ABSTRACT
Prostate cancer is the second most common life-threatening cancer in men in the majority of Western countries1, and accounted for over 31 000 deaths in the USA in 2000. Despite its major impact on public health, the etiology of prostate cancer is poorly understood, with the only recognized risk factors being age, family history and ethnicity2. The paucity of identified risk factors limits the opportunity for primary prevention, and attempts to reduce the burden of prostate cancer morbidity and mortality have increasingly focused on secondary prevention through early detection and treatment. Early detection is now largely achieved through use of the prostate-specific antigen (PSA) test, augmented with digital rectal examination and transrectal ultrasound. The aim of this form of cancer screening is avoidance of prostate cancer as a cause of death, and this chapter therefore focuses on this end-point.
