Prostate cancer is the most common cancer in men in the UK (24%) and has a death rate second only to lung cancer (13%) (Cancer Research UK). Incidence of prostate cancer has risen sharply over the last 20 years whereas mortality has only increased slightly. Prostate cancer is more common in older men and has a variable biologic course; therefore a gap between incidence and mortality has always been present due in part to death from intercurrent illness. Although factors such as improved treatment or changes in prostate cancer definition and coding may be responsible for the current rising discrepancy between incidence and mortality, increased uptake of prostate specific antigen (PSA) screening may play a role at detecting cancers that may not have become clinically significant.
PSA screening means that a prostate cancer will often be discovered earlier in its clinical course. Once a prostate cancer is detected a management strategy must be defined. If the cancer is indeed detected early, there are a variety of management options available to patients. The choice of treatment depends on many factors both specific to the disease and on the patient’s choice. The references given are intended predominantly to lead the reader to more detailed review articles and overviews.
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