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June 1, 1994


Author Affiliations

The University of Chicago Pritzker School of Medicine, Chicago,

JAMA. 1994;271(21):1717-1718. doi:10.1001/jama.1994.03510450089050

Last year, the Contempo section on urology discussed several issues involving benign and malignant prostatic disease. Since then interest has further increased, in part because several well-known individuals died of the disease and because new knowledge has been gained. Therefore, revisiting the topic is in order.

The diagnosis of carcinoma of the prostate is being made more often, with more than 165 000 cases detected in 1993 and 200000 projected for 1994. A likely explanation is widespread testing for the disease, especially by measuring prostate-specific antigen (PSA). Proponents of this test point to the increased proportion of tumors that are detected while still clinically and pathologically confined to the prostate as the obvious benefit of screening for this disease.1 A controversy exists, however, about whether screening of asymptomatic men should be recommended. The American Cancer Society and the American Urological Association recommend annual testing beginning at age 50 years,

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