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Editor's Correspondence
Less Is More
March 28, 2011

Time to Rethink PSA Screening

Author Affiliations

Author Affiliations: Division of Surgery and Interventional Sciences, University College London (UCL) (Drs Singh, Ahmed, Simmons, and Emberton), Department of Histopathology, University College Hospital (UCH) (Dr Freeman), and UCH/UCL Comprehensive Biomedical Research Centre (Dr Emberton), London England.

Arch Intern Med. 2011;171(6):595. doi:10.1001/archinternmed.2011.81

We read with interest the article by Shao et al1 looking at the risk profile of newly diagnosed prostate cancer and treatment patterns in the US population. The finding that men with screen-detected cancers and a PSA value less than 4 ng/mL were more likely to receive radical therapies despite having lower-risk disease is alarming. It will, however, come as no surprise to the uro-oncology community, which has debated the merits of therapy that causes significant genitourinary and bowel adverse effects2 but requires 12 men to be treated to extend the life of 1 man over a period of 15 years.3

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