It is also a question discussed in many prior issues of the CancerWeb Report . European physicians usually do not recommend general population screening for prostate cancer, in contrast to the US where the American Cancer Society recommends an annual PSA test for all men over 50. The surgical approach of prostatectomy frequently follows the finding of an elevated PSA and a positive biopsy. European reluctance to follow the same route stems in part from the perceived deficiencies of PSA, which does not always reflect the severity of the cancer. Also there is widespread concern that since most cases of prostate cancer disclosed by PSA are unlikely to progress significantly, surgery with its potential risks of incontinence, impotence and even mortality, may be worse for this large group of patients than no treatment at all.
Cost is another factor.
The problem is that there are no really adequate clinical data to strongly support any particular course of action. A major European study, coordinated by Drs. Denis and Schroeder at Erasmus University in Rotterdam, is underway to compare the outcome of screened populations versus those who did not undergo regular screening. Unfortunately, the results may not be known until the year 2008. The number also is lower among US blacks who have a higher incidence of and mortality from prostate cancer than whites.