Early diagnosis of prostate cancer.

Prostate cancer continues to be a leading cause of cancer death in American men. Since no studies have yet been reported that demonstrate a reduction in prostate cancer mortality, widespread prostate cancer screening by any modality must be considered experimental. Although, for an individual patient, screening may appear to have great potential benefit, when applied on a large scale, both the expense and potential morbidity could have a substantially negative impact on health care. These issues are too often ignored by enthusiasts of screening, but inevitably they will need to be addressed. Can society afford the expense of screening even if it does lead to reduced mortality? In addition, if health care resources are limited, is prostate cancer screening the best use of these funds? Finally, until the efficacy of prostate cancer screening is demonstrated by properly performed studies, it is essential that patients be told of both the potential risks and benefits of screening so that a fully informed decision can be made. Alternatively, should patients only be told that screening is clearly in their best interest? Currently, these questions have not been adequately addressed.