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Prostate cancer intervention

PREVIEW Prostate cancer is the most common malignancy diagnosed in men. Screening by prostate-specific antigen (PSA) testing is widespread in the United States, and treatment recommendations often urge early therapy. Yet there is ongoing controversy about patient care because of a lack of evidence demonstrating that such an aggressive approach improves the length and quality of a man's life. Drs Wilt and Partin review the epidemiologic factors of prostate cancer and discuss the research findings, recommendations, and pros and cons of screening and therapy. Further, they make a case that rather than routinely ordering a PSA test for all men, physicians should inform patients about the potential but uncertain benefits and the possible harm of screening and treatment and then incorporate patient preferences into decision making.