Early detection of prostate cancer by routine screening
G. W. Chodak and H. W. Schoenberg
In an attempt to detect prostate cancer when the disease was still
localized, a free screening clinic was established for men over the age of
45 years. Digital rectal examinations were performed for 811 men. Prostate
biopsy was recommended to 43 in whom abnormalities were found by digital
rectal examination; only 38 complied. Prostate cancer was detected in 11
men. The patients with cancer ranged in age from 60 to 79 years, with the
highest incidence of cancer in the group aged 70 to 79 years. The overall
incidence in men between 51 and 80 years old was 1.7%. Staging evaluation
revealed that none of the patients with prostate cancer had metastases to
the bone or elevated serum acid phosphatase levels. Five men (45%) were
found by clinical or pathological methods to have stage B disease. Two
others (18%) showed radiographic evidence of lymph node metastases (stage
D1). The cost of detecting each cancerous prostate tumor was approximately
+6,300. Routine screening can be a cost-effective method for diagnosing
prostate cancer in patients with less extensive disease. The ability of
early detection to prolong survival of patients with this disease will
require further investigation.
