This variety of perspectives appears to reflect in part the participants' diversity of professional backgrounds. However, it also significantly reflects the incomplete state of knowledge about treatment outcomes, and the effects of early detection efforts on death and disability in the population of men to whom such efforts are directed. It is normal in about one-third of men with clinically localized cancers, and is often elevated in men with noncancerous conditions such as benign prostate enlargement. However, its accuracy may be in the same range as other currently used cancer detection tests such as the mammogram and the fecal occult blood test. While the significance of these variables is not fully understood, further investigation may clarify their meaning and role, if any, in early detection.
Many uncertainties surround the appropriate treatment for men with early stage prostate cancer.
Future advances in knowledge about treatment outcomes may allow PSA to be used more effectively. In addition, the optimal time intervals and age limits for PSA testing have yet to be determined. TRUS is also used to guide biopsies in sampling abnormal areas of the prostate. However, the group of men who stand to benefit from treatment is ill defined, and is likely to have limits based on age, stage of cancer, and coexisting medical problems. In general, younger and healthier men are more likely to benefit from treatment than older and less healthy men.