Most patients with newly diagnosed prostate cancers have a normal DRE, and serum PSA measurement is not ideal as a screening test. As a result, in 2017, the United States Preventive Services Task Force reconsidered their 2012 recommendation against screening for prostate cancer (Level D) with a possible benefit (Level C) in men less than 70 years of age. Diagnosis is suggested by digital rectal examination. Symptoms are typically absent until tumor growth causes hematuria and/or obstruction with pain.

A pooled analysis of ERSPC (European Randomized Study of Screening for Prostate Cancer) and PLCO (Prostate, Lung, Colorectal, and Ovarian) trial data suggests that screening in both trials demonstrated a reduction in prostate cancer mortality when controlling for differences in screening intensity despite the high rate of contamination in the control arm of PLCO ( 1, 2 Diagnosis references Prostate cancer is usually adenocarcinoma. Screening is recommended by some professional organizations and discouraged by others. It is still not certain whether screening decreases morbidity or mortality or whether any gains resulting from screening outweigh the decreases in quality of life resulting from treatment of asymptomatic cancers.

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