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June 19, 1996


Author Affiliations

University of Connecticut Health Center, Farmington

JAMA. 1996;275(23):1857-1858. doi:10.1001/jama.1996.03530470085051

Controversy surrounding the early detection and management of prostate cancer continues to dominate the field of urology. During the past several years, prostate cancer screening using serum prostate-specific antigen (PSA) testing has become widespread in the United States. Although the American Cancer Society and the American Urological Association recommend that men older than 50 years undergo annual screening with a digital rectal examination and a serum PSA measurement, the US Preventive Services Task Force, the Canadian Task Force on the Periodic Health Examination, and the Canadian Urological Association do not support this practice.1 Four important questions related to this controversy were addressed by researchers in 1995: What is responsible for the rising incidence of prostate cancer? What are the test performance characteristics of serum PSA, and can they be improved? Does early detection improve outcomes? What is the net benefit and cost of widespread screening to society?

In 1995,