Prostate cancer facts and fiction
J Surg Oncol 1997;66(4):223-9

CR Smart

1. The observed increase in prostate cancer incidence followed by a
decrease, was not an epidemic, but the result of generalized prostate
cancer screening in the United States. 2. The increase showed a shift
in stage, to mainly early disease in grade 2 (Gleason's 4-6)
clinically significant cancers with a decrease in advanced disease.
3. There was an increase in the use of radical prostatectomy, mainly
in men 40 to 75 years of age with a 10-year relative survival rate of
100%. It appears that 15% were grade 1 cancers and in the absence of
more information may have been clinically unimportant. 4. There was a
20% increase in the overall relative survival rate for prostate
cancer. 5. There was a decrease in the incidence of advanced disease
followed by a 6.3% decrease in the United States mortality rate for
prostate cancer. 6. It appears that an annual PSA blood test and a
DRE on all men over 50 years of age followed by appropriate treatment
has decreased deaths from prostate cancer.