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Michael Pignone, MD, MPH

Arch Intern Med. 2009;169(17):1554-1556.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Prostate cancer is common (186 000 new US diagnoses in 2008), causing more than 28 000 deaths per year.¹ Treatment of clinically detected prostate cancer is effective in reducing prostate cancer mortality in men younger than 65 years but not in older men.² However, treatment of prostate cancer is associated with considerable morbidity; approximately 50% of men will have impotence, incontinence, or both after treatment, and a few will die as a result of initial treatment.³

Screening with the prostate-specific antigen (PSA) blood test (with or without digital rectal examination) can detect prostate cancer before it becomes symptomatic. However, screening also results in overdiagnosis; that is, it detects more prostate cancers than would otherwise be clinically recognized. Current methods cannot distinguish with great certainty whether a given cancer will progress, making prostate cancer screening a necessarily crude process at best. The decision about whether to be screened for . . . [Full Text of this Article]

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