[Is the mass screening for prostate cancer justifiable?]

Abstract

In Hungary, prostate cancer is a major public health problem, therefore screening should be considered to reduce the number of deaths. Screening tests are available, i.e. prostate-specific antigen (PSA) and digital-rectal examination, nevertheless their sensitivity, specificity and positive predictive value are far from being perfect. Evidences from non-randomized screening trials suggest possible benefit but randomized controlled trials are still needed for conclusive evidence. The screening might cause more harm than good due to overdiagnosis and overtreatment as a result of limited specificity of the test. According to authors' point of view, opportunistic screening as part of diagnostics of patients having symptoms indicative of prostatic disorder is fully justified but mass screening of population of average risk should not be introduced until supportive evidence is available from the ongoing randomized-controlled screening trials.