Should mass screening for prostate cancer be introduced at the national level?

Summary

The issue

Prostate cancer is a major cause of death among men, with over 56,000 deaths in the European Union in 1998. There are no obvious preventive strategies, therefore screening has been considered to reduce the number of deaths. Opportunistic screening is widely carried out but there are no known national programmes to screen for prostate cancer.

Findings

There are no completed randomized screening trials, although two are underway. Evidence from non-randomized studies suggests possible benefit, but these results may not be reliable due to bias or alternative explanations. The main areas of uncertainty are the natural history of the disease, which appears relatively benign in many cases, and appropriate treatment for positive screened cases.

Policy considerations

Mass screening should not be introduced at the national level, unless supportive evidence is available from the ongoing screening or treatment trials.