The dilemmas of prostate cancer screening

Jonas Hugosson and Sigrid V Carlsson
Med J Aust 2013; 198 (10): . || doi: 10.5694/mja13.10242
Published online: 3 June 2013

Prostate cancer screening is controversial — the screening decision must be based on high-quality evidence

Screening for cancer, especially screening for prostate cancer with prostate-specific antigen (PSA), is one of the most controversial subjects in medicine today. The main dilemma is that one aims for a beneficial effect on the population level, but on the individual level, some will only be harmed without any gain from participation — such as those in whom the cancer detected is already too advanced at diagnosis, and those diagnosed with a harmless disease that will not surface as a clinical cancer during the lifetime (overdiagnosis). These individuals will unnecessarily be “labelled” as patients for many years, are likely to be treated unnecessarily and suffer from the side effects of treatment (overtreatment) without altering the risk of prostate cancer mortality.

  • Jonas Hugosson1
  • Sigrid V Carlsson1,2

  • 1 Department of Urology, University of Gothenburg, Gothenburg, Sweden.
  • 2 Department of Surgery, Urology Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.


Competing interests:

No relevant disclosures.


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