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Peter Goodwin, MD; Eric Wall, MD, MPH
Oregon Health Sciences University Portland

JAMA. 1992;268(22):3196.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—We were confused by the recommendations contained in the Editorial by Oesterling¹ concerning the evaluation of older males for prostatic carcinoma.

The article by Johansson et al² demonstrated a 10-year disease-specific survival rate of 86.8%, with 19 of 223 patients dying of their prostatic cancer, while 105 died from other causes. The authors mentioned ongoing trials in Scandinavia comparing radiation with no initial treatment, and radical prostatectomy with deferred treatment. They contend that without evidence of benefit, the radical treatment of early stage prostatic cancer remains highly controversial.

In a Preliminary Communication, Carter et al³ provide evidence that the annual rate of change in PSA levels was significantly greater in subjects with prostatic cancer compared with normal subjects and those with benign prostatic hypertrophy. They emphasize the lack of specificity (60%) and the relative insensitivity (78%) of PSA testing on a onetime basis, when . . . [Full Text PDF of this Article]

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