Individual and mass screening

Screening for prostate cancer is one of the main current health issues nowadays. As prostate cancer is the most frequently diagnosed cancer affecting over 10% of men in the Western world, early detection by mass screening or by individual approaches has to be considered in order to reduce disease-specific morbidity and mortality. Randomized studies on population-based screening show a significant specific mortality reduction of 30%, but current screening protocols are unacceptable and need adjustment in order to reduce unnecessary biopsy procedures and overdiagnosis of low-risk cancers. The incidence of interval cancers has to be lowered, and screening intervals need to be individualized. Quality of life appears to be improved for those that are diagnosed with intermediate and high-risk cancers. Individual screening can be performed based on adequate information upfront, followed by the application of validated risk calculators including especially the level of serum markers, digital rectal examination, and prostate volume. A strong need for the development of prognostic tools remains.