research
Population Based Screening for Prostate Cancer: assessment of diagnostic tools and cancers detected
- Publication date
- 2 December 1998
- Publisher
- Over the past decade, considerable debate has occurred over the question whether
or not to screen asymptomatic men for prostate cancer. It is unknown whether
early detection and treatment of the disease will decrease the disease specific mortality.
On theoretical grounds screening may prove to be successful. If the disease is diagnosed
at an earlier stage of its development in which it is still organ-confined; treatment of the
disease has a higher chance of being curative. Comparisons have been made [1, 2]with
the effective strategy [3, 4J of breast cancer screening. Similar parallels however, can be
drawn between prostate and lung cancer screening in which a shift towards earlier
(potentially curable) stage did not reduce ti,e disease specific mortality in screenees [5].
To conduct a randomized screening study with prost.lte cancer mortality as the major
endpoint is one possible solution to the present controversy. For this purpose the
European Randomized Study of Screening for Prostate Cancer (ERSPC) has been
initiated [6]. The studies presented in this thesis are conducted within the Rotterdam
section of the ERSPC to investigate the feasibility of screening and early detection of
prostate cancer in the general population. Intermediate endpoints of the study are:
1. Assessment of the efficiency of the screening tests. Serum Prostate Specific Antigen
(PSA) Digital Rectal Examination (DRE) and Transrectal Ultrasonography (TRUS).
2. To evaluate the morbidity related to the screening procedure.
3. To study tumor extent at the time of diagnosis.