General Considerations

Prostate cancer is the most commonly diagnosed cancer in American men and the second leading cause of cancer deaths. More than 234,460 men will be diagnosed with prostate cancer in 2006, and an estimated 27,350 patients will die of this disease.

During the same period, nearly 20 million men in the United States will be confronted with important decisions regarding early detection for prostate cancer. Men in the United States have about one chance in six of eventually being diagnosed with this malignancy and about one chance in 30 of eventually dying of it.

The decision about whether to pursue early detection of prostate cancer is complex. In brief, the dilemma is that because not all men with prostate cancer will die of this disease, treatment is not necessary for some patients. Conversely, prostate cancer remains the third most common cause of male cancer deaths. Therefore, differentiating between patients whose cancer is clinically insignificant and those whose disease will progress is a challenge.

To meet this challenge, several medical organizations have developed prostate cancer detection guidelines. The American Cancer Society (ACS), the American Urological Association (AUA) and the National Comprehensive Cancer Network (NCCN) were the first groups to make definitive recommendations for the early detection of prostate cancer, advising men to obtain an annual digital rectal examination (DRE) and serum PSA test beginning at age 50 in the absence of specific risk factors and earlier for those in high-risk groups. If the PSA level is above a designated threshold, indicating an increased risk, further testing, usually including a prostate biopsy, is indicated because a prostate biopsy is the only way to diagnose prostate cancer.

The ultimate goal of prostate cancer early detection is diagnosis of the disease at the earliest stage possible which affords men the best chances of successful treatment and complete recovery.

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