ABSTRACT
For men in the USA, prostate cancer is the most common major cancer and the second most common cause of cancer death. In 2002, it is estimated that there will be 189 000 new cases and 30 200 deaths, a marked decline from 1993 when 43 000 died from the disease1,2. The cause for this dramatic decrease in mortality is not known for certain, but it is widely believed that it is secondary to diagnosis at an earlier stage with effective treatment. One would assume that with time these statistics would improve. Unfortunately, this is not the case. The ‘baby boomers’, children born immediately following the end of World War II, represent almost one-quarter of the population in the USA: 80 million men and women. In 4 years the first wave of individuals in this large group will turn 60 years of age, the year when the age-specific diagnoses of breast and prostate cancer are equal. Thereafter, with aging, the incidence of prostate cancer begins to exceed the incidence of breast cancer, and it is believed that within 20-40 years, unless there is a continued dramatic improvement in the management of prostate cancer, there will be an estimated 100 000 men who will die from prostate cancer, and prostate cancer will overtake breast cancer as a cause of death (Chan, unpublished observations). This observation emphasizes the urgency in addressing the question raised by the title of this chapter.
