Screening for urologic malignancies in primary care: pros, cons, and recommendations.

Interest in screening for urologic cancers has grown in recent years. This article considers the pros and cons of screening for four epidemiologically compelling urologic cancers: prostate, bladder, kidney, and testicular. Unfortunately, many of the urologic cancers do not meet the criteria for a successful cancer screening program-namely, high prevalence, availability of a sensitive and specific screening test, ability to detect clinically important cancers at an early stage, and cost-effectiveness. While age-based screening for prostate cancer should be offered to the general population after discussion of its benefits and risks, for the other three urologic malignancies the current consensus points more toward selective screening based on specific patient risk factors.