Prostate Cancer

Screening for prostate cancer is technically feasible. Recent advances in diagnostic strategies have led to a significant stage shift at the time of diagnosis in the direction of disease that is confined to the prostate clinically and histologically. This chapter updates available information relevant to the issue of early detection and screening for prostate cancer. Prostate cancer incidence is increasing rapidly, and there is a slow increase in prostate cancer mortality rate in the United States and other countries of the world, mainly those with a Western type of lifestyle. Geographical variation in incidence is impressive and amounts to about 100-fold if the areas of highest and lowest incidence are compared. Many reports connect the recent increase in prostate cancer incidence, especially in the United States but also in European countries, to the use of PSA-driven screening. Digital rectal examination is the classical technique for the detection of prostate cancer