PRIMARY CARE physicians should not be routinely screening for prostate cancer. There is no conclusive evidence that screening is effective in reducing prostate cancer morbidity and mortality, but there is considerable evidence that screening and treatment can be harmful. Primary care physicians should routinely discuss screening, but patients need to make an informed decision to be screened.
Prostate cancer is an important public health problem—a devastating disease that was expected to have killed more than 30 000 American men in 2002.1 Unfortunately, our current prevention and treatment strategies are limited in their ability to reduce the burden of suffering from prostate cancer. The strongest risk factors are age, race, and family history, none of which can be modified. Although dietary micronutrients, antioxidant vitamins, and finasteride are being studied for the primary prevention of prostate cancer, we currently have no proven prevention strategy. Men with advanced cancers can be treated only with palliative therapy. Consequently, there has been great interest in detecting prostate cancers at an early, asymptomatic stage, especially since the discovery of PSA. The hope is that detecting early stage cancers and treating them aggressively with surgery or radiation will reduce morbidity and mortality from prostate cancer. The American Urologic Association2 and the American Cancer Society3 support routine screening for prostate cancer using PSA and DRE. However, other professional organizations, such as the American College of Physicians–American Society of Internal Medicine4 and the US Preventive Services Task Force5 recommend against routine screening.
Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more
Subscribe for full-text access to content from 1998 forward and a host of useful features
Activate your current subscription (AMA members and current subscribers)
Purchase Online Access to this article for 24 hours
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
Instructions
Thank you for submitting a comment on this article. It will be reviewed by JAMA Internal Medicine editors. You will be notified when your comment has been published. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest* Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers’ bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 10
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
and access these and other features:
Register Now
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Need assistance?
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.