ROUTINE SCREENING for prostate cancer remains a controversial topic. Prostate cancer is the most common cause of cancer of men in the United States and caused more than 30 000 deaths in 1999. It involves a wide pathophysiologic spectrum, from indolent disease to rapid growth and metastasis. A continued increase in frequency of prostate cancer is expected as the baby boom generation reaches the higher-risk age range for the disease. The main approaches to manage the disease include prevention, early detection (screening) and treatment, and effective treatment of advanced and/or metastatic disease. Currently, prostate-specific antigen (PSA) is the most important tumor marker for the detection, staging, and monitoring of men with prostate cancer.1