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April 9, 1997

Is Prostate Cancer Screening Analogous to Lung Cancer Screening?

Author Affiliations

Cancer Institute of New Jersey New Brunswick, NJ

JAMA. 1997;277(14):1120. doi:10.1001/jama.1997.03540380034015

To the Editor.  —Drs Collins and Barry1 raise a number of important concerns about the use of screening for prostate cancer. Because the way in which questions are framed helps determine the techniques used to develop answers, we feel their concerns should be refocused. We believe 2 separate major questions need to be addressed: (1) Will screening for prostate cancer reduce morbidity, mortality, or both? (2) How aggressively should diagnosed prostate cancer be treated? Answers to the first question hinge on issues of cost-effectiveness. Answers to the second question hinge on issues of risk and effectiveness of treatment.Collins and Barry conclude that caution is necessary "regarding widespread dissemination of prostate cancer screening without the experimental evidence that such screening does more good than harm."1 We believe this statement confounds the 2 questions and could therefore impede the search for answers.Whether to screen for prostate cancer is