There is increasing pressure on doctors to test men for the early detection of prostate cancer. Unlike breast cancer screening, which has been shown to reduce mortality, prostate cancer screening has not yet been evaluated and there are several reasons why it may be less effective. Many men with prostate cancer never experience any ill effects because some tumours are slow growing and not aggressive. However, the PSA test and follow up biopsies cannot preduct reliably whether a man has a cancer that will progress to cause ill health or death. There have been no reliable evaluations of the effect of treatments for early prostate cancer on mortality.
Active treatments can result in major complications such as incontinence and impotence.
Screening may lead to physical and psychological harm resulting from testing, biopsy and treatment. It is not known whether screening for prostate cancer does more good than harm. Public awareness of benign and malignant prostate disease is increasing. However, the appropriateness of testing for early stage prostate cancer is uncertain. This bulletin summarises research evidence about the effectiveness of prostate cancer screening.