Prostate cancer screening and the management of clinically localized disease

Prostate cancer is an important health problem. More than 40 000 incident cases of prostate cancer and more than 10 000 prostate cancer related deaths occur each year in the United Kingdom. 1 Prevention, detection, and treatment of localized prostate cancer remain controversial. Although screening for prostate cancer with serum prostate specific antigen (PSA) testing is not approved in the UK, informal screening is common and has led to a threefold increase in the incidence of prostate cancer. In the United States, since the introduction of PSA screening more than 1.3 million men have been diagnosed with prostate cancer and one million of these have undergone treatment. We update a previous review, highlighting new findings that deal with clinical questions and future research needs for the prevention, detection, and treatment of clinically localized prostate cancer.