So it is pay now or pay later. There is a marked difference in mortality when clinically significant prostate cancer goes untreated. Medical authorities in the USA have consistently ignored such studies even though the evidence of the natural history of prostate cancer is well documented. Early detection and treatments have not been proven to improve survival. This statement is based not on any positive evidence against early detection but on the lack of randomized, controlled trials.
Trials are ongoing in Europe and America.
Unfortunately these trials will not mature until 2005 to 2010. In the USA alone this could result in 26,000 fewer deaths a year. These are very significant numbers. The survival benefit is much higher in aggressive disease than it is in lower disease grades, in which the 10-year survival is almost equal for both. Most men with low grade disease who are surgically treated do not have to contend with disease progression at 10 years.