Cancer of the prostate: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up.

Subclinical prostate cancer is common in men >50 years of age. Population-based screening of men aged between 55 and 69 years, using prostate-specific antigen (PSA) testing, has been evaluated in randomised trials [1, 2]. After a median follow-up of 13 years, the European screening trial demonstrated a relative reduction in the risk of prostate cancer mortality of 21% (29% if adjusted for non-compliance). However, 781 men needed to be invited for screening and 27 patients needed to be treated to prevent one death from prostate cancer. Risk-adapted early detection of prostate cancer using a baseline PSA level has also been evaluated in retrospective cohort studies. The baseline PSA at or before the age of 50 years is associated with the risk of prostate cancer mortality over the subsequent 25 years [3].