Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Viewpoint
  • Published:

Prostate cancer: risks and benefits of screening

Nature Clinical Practice Urology volume 3, pages 4–5 (2006)Cite this article

Since PSA screening for prostate cancer became available in the late 1980s, both prostate cancer incidence and mortality rates have changed profoundly. Between 1989 and 2002, for example, the age-standardized incidence rate of prostate cancer increased by 38.7% in The Netherlands (reaching an incidence of 87.1 cases per 100,000 men),1 and by 21.3% in the US (reaching 176.3 per 100,000 men).2 It is now the most frequently diagnosed non-cutaneous cancer, with 225,000 new cases reported each year in Europe alone.3 Moreover, autopsy studies have revealed that prostate cancer occurs in an even larger proportion of men: 55% of men in their fifties, and 64% of men in their seventies.4 If the current trends toward using lower PSA thresholds to determine the need for biopsy, and taking more core samples per biopsy continue, the number of living men diagnosed with prostate cancer will increase even further.

Despite this rising incidence, the age-standardized prostate cancer mortality rate in The Netherlands fell by 8.5% between 1989 and 2002, to 29.2 deaths per 100,000 men;1 in the US it fell by 17.6%, to 28.1 per 100,000 men during the same period.2 Whether this decrease is the result of screening or of improvements in treatment remains a matter for debate.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

References

  1. Dutch Comprehensive Cancer Center [http://www.ikcnet.nl]

  2. US National Cancer Center [http://www.cancer.gov]

  3. Parkin D et al. (2005) Global cancer statistics, 2002. CA Cancer J Clin 55: 74–108

    Article  Google Scholar 

  4. Sakr WA et al. (1994) High grade prostatic intraepithelial neoplasia (HGPIN) and prostatic adenocarcinoma between the ages of 20–69: an autopsy study of 249 cases. In Vivo 8: 439–443

    CAS  PubMed  Google Scholar 

  5. de Koning HJ et al. (2002) Large-scale randomized prostate cancer screening trials: program performances in the European Randomized Screening for Prostate Cancer trial and the Prostate, Lung, Colorectal and Ovary cancer trial. Int J Cancer 97: 237–244

    Article  CAS  Google Scholar 

  6. Draisma G et al. (2003) Lead times and overdetection due to prostate-specific antigen screening: estimates from the European Randomized Study of Screening for Prostate Cancer. J Natl Cancer Inst 95: 868–878

    Article  Google Scholar 

  7. Raaijmakers R et al. (2002) Complication rates and risk factors of 5802 transrectal ultrasound-guided sextant biopsies of the prostate within a population-based screening program. Urology 60: 826–830

    Article  Google Scholar 

  8. Essink-Bot ML et al. (1998) Short-term effects of population-based screening for prostate cancer on health-related quality of life. J Natl Cancer Inst 90: 925–931

    Article  CAS  Google Scholar 

  9. Klotz LH (2005) Active surveillance for good risk prostate cancer: rationale, method, and results. Can J Urol 12 (Suppl 2): 21–24

    PubMed  Google Scholar 

  10. Hewitson P and Austoker J (2005) Part 2: Patient information, informed decision-making and the psycho-social impact of prostate-specific antigen testing. BJU Int 95 (Suppl 3): 16–32

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Urology at the Erasmus MC, University Medical Center, Rotterdam, The Netherlands

    Stijn Roemeling & Fritz H Schröder

  2. Professor of Urology at the Erasmus MC, University Medical Center,

    Stijn Roemeling & Fritz H Schröder

Authors
  1. Stijn Roemeling
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Fritz H Schröder
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Stijn Roemeling.

Ethics declarations

Competing interests

The authors declare no competing financial interests.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Roemeling, S., Schröder, F. Prostate cancer: risks and benefits of screening. Nat Rev Urol 3, 4–5 (2006). https://doi.org/10.1038/ncpuro0374

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ncpuro0374

Search

Advanced search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing