The role of new modalities in the early detection and diagnosis of prostate cancer.

New as well as standard techniques for the detection and diagnosis of early prostate cancer have been described. These include the use of digital rectal examination, prostate-specific antigen, transrectal ultrasound, prostatic acid phosphatase, the Biopty gun, and cell ploidy, as well as the diagnosis of premalignant lesions of the prostate, such as prostatic dysplasia or, more appropriately, prostatic intraepithelial neoplasia. All of these innovations may enhance our ability to diagnose and follow patients with early prostate cancer. Full documentation and evaluation of long-term (15 to 20 years) follow-up, however, are needed to determine whether these new techniques will make a difference in the ultimate morbidity and mortality of prostate cancer in the United States. In the meantime, however, the use of these new diagnostic tools should not be avoided. We must advance with technology, and as the technologies grow and develop we should increase our understanding about the utility of each of these new tests and combine them with the older standard tests that have served us well for many years.