Prostate cancer: screening and early detection update.

Many questions still exist about the etiology of prostate cancer. Prostate cancer screening methods continue to evolve. The following four findings are important to remember: (1) PSA is organ specific, not cancer specific, (2) DRE remains the standard method for screening, (3) TRUS continues to evolve but is currently too expensive to use as a screening modality, and (4) a combination of DRE and PSA is the most effective and cost-efficient screening method. Although screening methods are controversial, mass screening for prostate cancer is already occurring in several cities in the United States. An understanding of the value and limitations of the available screening tools is essential.