PSA screening remains highly controversial due to several important disadvantages. More PSA is produced with prostatic enlargement and in other benign conditions such as urinary tract infections. False positive tests can then lead to unnecessary diagnostic workup with invasive prostate biopsy. Another major problem with screening programs in general is overdiagnosis of cancers that would not have caused harm during the patient's lifetime. For example, many prostate cancers have a relatively indolent behavior so may not require diagnosis or treatment in a patient with limited life expectancy. All forms of prostate cancer treatment have potential urinary and sexual side effects, so reducing overdiagnosis and overtreatment are critical public health issues. Because screening has many proven benefits but also significant harms, there are widely disparate guidelines on prostate cancer screening from major organizations worldwide. This issue of the Urologic Clinics will provide insights into the many different prostate cancer guidelines and related policy issues.
1. Cover image - p. 1 2. Title page - p. 2 3. Table of Contents - p. 3 4. CME Accreditation Page and Author Disclosure - p. 4 5. Contributors - p. 5 6. Forthcoming Issues - p. 6 7. Foreword: Early Detection of Prostate Cancer - p. 7 8. Preface: Early Detection of Prostate Cancer - p. 8 9. What Do the Screening Trials Really Tell Us and Where Do We Go From Here? - p. 9 10. Evolution and Immediate Future of US Screening Guidelines - p. 14 11. International Perspectives on Screening - p. 20 12. The Politics of Prostate Cancer Screening - p. 27 13. Decision Making and Prostate Cancer Screening - p. 32 14. Emerging PSA-Based Tests to Improve Screening - p. 40 15. The Epidemiology and Clinical Implications of Genetic Variation in Prostate Cancer - p. 49 16. Optimization of Prostate Biopsy - p. 59 17. Screening and Detection Advances in Magnetic Resonance Image–Guided Prostate Biopsy - p. 72 18. Management of an Increasing Prostate-Specific Antigen Level After Negative Prostate Biopsy - p. 78 19. When is Prostate Cancer Really Cancer? - p. 87 20. Index - p. 93
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PSA screening remains highly controversial due to several important disadvantages. More PSA is produced with prostatic enlargement and in other benign conditions such as urinary tract infections. False positive tests can then lead to unnecessary diagnostic workup with invasive prostate biopsy. Another major problem with screening programs in general is overdiagnosis of cancers that would not have caused harm during the patient's lifetime. For example, many prostate cancers have a relatively indolent behavior so may not require diagnosis or treatment in a patient with limited life expectancy. All forms of prostate cancer treatment have potential urinary and sexual side effects, so reducing overdiagnosis and overtreatment are critical public health issues. Because screening has many proven benefits but also significant harms, there are widely disparate guidelines on prostate cancer screening from major organizations worldwide. This issue of the Urologic Clinics will provide insights into the many different prostate cancer guidelines and related policy issues.
1. Cover image - p. 1 2. Title page - p. 2 3. Table of Contents - p. 3 4. CME Accreditation Page and Author Disclosure - p. 4 5. Contributors - p. 5 6. Forthcoming Issues - p. 6 7. Foreword: Early Detection of Prostate Cancer - p. 7 8. Preface: Early Detection of Prostate Cancer - p. 8 9. What Do the Screening Trials Really Tell Us and Where Do We Go From Here? - p. 9 10. Evolution and Immediate Future of US Screening Guidelines - p. 14 11. International Perspectives on Screening - p. 20 12. The Politics of Prostate Cancer Screening - p. 27 13. Decision Making and Prostate Cancer Screening - p. 32 14. Emerging PSA-Based Tests to Improve Screening - p. 40 15. The Epidemiology and Clinical Implications of Genetic Variation in Prostate Cancer - p. 49 16. Optimization of Prostate Biopsy - p. 59 17. Screening and Detection Advances in Magnetic Resonance Image–Guided Prostate Biopsy - p. 72 18. Management of an Increasing Prostate-Specific Antigen Level After Negative Prostate Biopsy - p. 78 19. When is Prostate Cancer Really Cancer? - p. 87 20. Index - p. 93
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