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International Journal of Epidemiology 2007 36(2):282-284; doi:10.1093/ije/dym052
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Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2007; all rights reserved.

Commentary: Implications of the frequent occurrence of occult carcinoma of the prostate

Anthony B Miller

Emeritus, Department of Public Health Sciences University of Toronto. E-mail: ab.miller@sympatico.ca

Keywords Overdiagnosis, latent prostate cancer, screening

Accepted 13 November 2006

The first 150 words of the full text of this article appear below.

Screening for cancer of the prostate is dependent upon a sensitive test for cancer, so far no identifiable precursor has been identified for which a test could be developed. This is a situation similar to screening for breast cancer, but not, of course, for either cervix or colorectal cancer, though it seems probable that much of the benefits following screening for colorectal cancer by the faecal occult blood test are due to detection of early cancers, and not just adenomatous polyps.

Of the available screening tests for prostate cancer, digital rectal examination (DRE) and a blood test for prostate-specific antigen (PSA), it is the latter on which most hope resides for a reduction in prostate cancer mortality. Two large trials are ongoing incorporating DRE and PSA screening, the European Randomised Screening trial of Prostate Cancer (ERSPC) in seven European countries,1 and the Prostate, Colon, Lung and Ovary Trial (PLCO) in . . . [Full Text of this Article]


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