Screening for Prostate Cancer in the Aging Population: Current and Future Trends

Abstract

The death rate from prostate cancer continues to decline in the USA despite an increased incidence of disease observed with the introduction of the prostate-specific antigen in the 1990s. It is not clear whether the decline is due to changes in mortality record-keeping, screening, stage migration or treatment of the disease. Since the treatment of localized prostate cancer has been shown to improve overall survival compared with observation in a randomized, controlled, landmark trial, many feel that the improvement in mortality may be due, at least in part, to screening and treatment. Despite possible improvements in mortality as a result of screening for prostate cancer, it is equally important to avoid over-treatment. An obvious area of risk for over-treatment lies in men over 70 years of age. This article aims to evaluate the risks and benefits of screening for prostate cancer in elderly males.