There are calls for a national screening programme for prostate cancer: what is the evidence to justify such a national screening programme?

INTRODUCTION

Prostate cancer is the commonest cancer in men and a major health issue worldwide. Screening for early disease has been available for many years, but there is still no national screening programme established in the United Kingdom.

OBJECTIVE

To assess the latest evidence regarding prostate cancer screening and whether it meets the necessary requirements to be established as a national programme for all men.

METHODS

Electronic databases and library catalogues were searched electronically and manual retrieval was performed. Only primary research results were used for the analysis.

RESULTS

In recent years, several important randomised controlled trials have produced varied outcomes. In Europe the largest study thus far concluded that screening reduced prostate cancer mortality by 20%. On the contrary, a large American trial found no reduction in mortality after 7-10 years follow-up. Most studies comment on the adverse effects of screening - principally those of overdiagnosis and subsequent overtreatment.

DISCUSSION: Further information about the natural history of prostate cancer and accuracy of screening is needed before a screening programme can be truly justified. In the interim, doctors and patients should discuss the risks, benefits and sequelae of taking part in voluntary screening for prostate cancer.