Document Detail

Does screening for prostate cancer identify clinically important disease?
MedLine Citation:
PMID:  10364958     Owner:  NLM     Status:  MEDLINE    
In this study the combination of digital rectal examination (DRE) and serum prostate-specific antigen (PSA) is shown to be effective for detecting early prostate cancer in a urological out-patient setting. PSA provides the means to detect cancer in men with normal DRE that may otherwise present as so-called incidental cancer at transurethral resection of the prostate (TURP) for apparently benign disease or later in the course of its natural history as locally advanced or metastatic disease. PSA progression in men with incidental cancer has been previously demonstrated to be predicted more reliably by residual cancer on needle biopsy after TURP than by tumour in the resected specimen and, therefore re-staging such patients is worthwhile when further treatment would be considered. Among men selected for radical prostatectomy, non-palpable tumours detected with PSA more predictable in pathological extent than incidental cancer and their particular pathological characteristics suggest they include clinically significant tumours that would progress if untreated to palpable and eventually metastatic disease. In view of this progressive behaviour, cancer detected by PSA should be considered clinically significant particularly in men with a life expectancy of at least 10 years. Therefore screening should be offered for such individuals, to detect and treat tumours at a curable stage and thereby eliminate the high mortality and often protracted morbidity commonly associated with metastatic disease.
M R Feneley
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of the Royal College of Surgeons of England     Volume:  81     ISSN:  0035-8843     ISO Abbreviation:  Ann R Coll Surg Engl     Publication Date:  1999 May 
Date Detail:
Created Date:  1999-06-23     Completed Date:  1999-06-23     Revised Date:  2010-09-10    
Medline Journal Info:
Nlm Unique ID:  7506860     Medline TA:  Ann R Coll Surg Engl     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  207-14     Citation Subset:  IM    
Brady Urological Institute, Johns Hopkins Hospital, Baltimore, USA.
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MeSH Terms
Aged, 80 and over
Biopsy, Needle
England / epidemiology
Mass Screening*
Middle Aged
Patient Selection
Physical Examination
Predictive Value of Tests
Prospective Studies
Prostate / pathology
Prostate-Specific Antigen / blood
Prostatic Intraepithelial Neoplasia / diagnosis*
Prostatic Neoplasms / diagnosis*,  epidemiology,  surgery
Sensitivity and Specificity
Wales / epidemiology
Reg. No./Substance:
EC Antigen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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