Screening for prostate cancer: Early detection or overdetection? Review uri icon


MeSH Major

  • Mass Screening
  • Prostatic Neoplasms
  • Unnecessary Procedures


  • A sophisticated reading of the randomized trial evidence suggests that, although screening for prostate cancer with prostate-specific antigen (PSA) can reduce cancer-specific mortality, it does so at considerable cost in terms of the number of men who need to be screened, biopsied, and treated to prevent one death. The challenge is to design screening programs that maximize benefits (reducing prostate cancer mortality) and minimize costs (overtreatment). Recent research has suggested that this can be achieved by risk-stratifying screening and biopsy; increasing reliance on active surveillance for low-risk cancer; restricting radical prostatectomy to high-volume surgeons; and using appropriately high-dose radiotherapy. In current U.S. practice, however, many men who are screened are unlikely to benefit, most men found to have low-risk cancers are referred for unnecessary curative treatment, and much treatment is given at low-volume centers.

publication date

  • January 23, 2012



  • Review



  • eng

PubMed Central ID

  • PMC3415315

Digital Object Identifier (DOI)

  • 10.1146/annurev-med-050710-134421

PubMed ID

  • 22053739

Additional Document Info

start page

  • 161

end page

  • 70


  • 63