Screening for prostate cancer.

PURPOSE/OBJECTIVES: To describe current prostate cancer screening methods and to address the controversies surrounding their use.

DATA SOURCES

Published articles, abstracts, books, and press releases; personal communication.

DATA SYNTHESIS

Controversy exists about whether efforts to conduct mass screenings for prostate cancer are of value given the related costs and the inability of such screenings to distinguish between indolent and aggressive tumors. The American Cancer Society (ACS) has added prostate cancer to its "Guidelines for the Cancer-Related Checkup" but does not recommend these guidelines for mass screenings. Preliminary findings of the ACS National Prostate Cancer Detection Study have shown that digital rectal examination (DRE) and transrectal ultrasonography (TRUS) have the best positive predictive value when the prostate-specific antigen (PSA) level is greater than 4 ng/ml.

CONCLUSIONS

Despite concern over the rising incidence of prostate cancer, the effectiveness of DRE, PSA, and TRUS in screening for early detection of prostate cancer remains controversial.

IMPLICATIONS FOR NURSING PRACTICE

As the public becomes more aware of the controversies surrounding prostate cancer screening, nurses are finding that they play a vital role in the educational process. By understanding the abilities and deficiencies of the current screening methods, nurses can offer men concrete information about DRE, PSA, and TRUS. They can reinforce the importance of early detection for high-risk populations, as well as suggest strategies for encouraging compliance.