The dilemmas of prostate cancer screening

To the Editor: Recent articles in the Journal evaluating the evidence on screening for early-stage prostate cancer1,2 failed to mention one of the most important pieces of evidence ever published on the treatment of prostate cancer.3 This randomised controlled trial (RCT) showed that, compared with observation, radical prostatectomy did not significantly reduce all-cause or prostate cancer mortality over at least 12 years among men with clinically localised prostate cancer diagnosed in the era of prostate-specific antigen (PSA) testing.3