Screening for prostatic cancer. Investigational models

Prostatic cancer has a long natural history and a significant preclinical period, during which the disease is detectable. Thus, this common malignancy in males fulfills some of the most important criteria for initiating screening programs. However, the still enigmatic epidemiology also includes features of the disease, which make the possible gain from screening programs questionable. Thus, before embarking on expensive community or national screening programs, the beneficial effect of such an effort on morbidity and mortality must be demonstrated in large-scale trials comparing a screened population with non-screened controls. In this paper, some of the problems associated with such studies are addressed.