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Murray D. Krahn, MD, MSc; John E. Mahoney, MD; Allan S. Detsky, MD, PhD; John Trachtenberg, MD
The Toronto Hospital Toronto, Ontario

Mark H. Eckman, MD; Stephen G. Pauker, MD
Tufts University School of Medicine Boston, Mass

JAMA. 1995;273(15):1175-1176.

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

In Reply.

—For screening to be a rational strategy, patients identified as having prostate cancer must, on average, have better outcomes than patients not identified by screening. Because such benefit has not yet been demonstrated by any randomized trial, clinicians and patients must use the best information at hand to make their personal decisions. Dr Miles and colleagues suggest that the study by Johannson et al¹ may not be the best data on patients with early, untreated prostate cancer because that study may provide an overly optimistic view of natural history. In fact, the distribution of tumor grades and the cause-specific survival rates by grade in that study are similar to those reported by Chodak et al²: Johannson et al reported the proportion of grade 1, 2, and 3 tumors as 0.66, 0.30, and 0.04, respectively, whereas the meta-analysis of Chodak et al reported 0.60,0.32, and 0.08, respectively; . . . [Full Text PDF of this Article]

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