Screening, diagnosis, and management of prostate cancer: improving primary care outcomes.

Prostate cancer (PC) resulted in more than 41,000 related deaths in 1996. However, much confusion exists about when and whom to screen and treat for PC. Guidelines opposing the early detection and treatment of PC are based on outcomes from diagnoses and treatments made prior to recent improvements in screening and treatment methods. More recently, prostate specific antigen has been shown to be both specific and sensitive in detecting PC at an early, curable stage. Several options for treating early PC now exist: anatomic radical prostatectomy, external beam radiation, implanted radiation seeds, and cryotherapy. Informed primary care providers have an opportunity to make individualized, rational decisions that will promote better outcomes for men with PC.