Prostate cancer: the new evidence base for diagnosis and treatment

Abstract
Although prostate cancer (PC) has a significant mortality, there is debate regarding the utility of PC screening. This debate continues as major studies investigating the value of population-based screening have yet to be concluded. Despite this, there is increasing evidence from preliminary reports from these series, as well as numerous others relating to outcome prediction for PC, that early detection leads to improved outcomes and a decrease in the burden of metastatic disease on our healthcare system. PC is rarely symptomatic until it has metastasised to bone and because of this PSA-based screening remains the only widely available and reliable method of diagnosis for organ-confined disease. There is now compelling evidence to show that: