The European Randomised Study of Screening for Prostate Cancer demonstrated a 21% relative risk reduction of death from prostate cancer in the screening group versus patients not offered PSA screening at a median follow up of 11 years. Nonetheless, mass PSA screening remains controversial. Despite its limitations, the advent of PSA testing has led to a considerably higher number of curable presentations. Because rectal examination has a low sensitivity and prostate cancer is asymptomatic until the late stages, most men had advanced and incurable disease at presentation. 5 In the past, digital rectal examination (DRE) provided the main approach for suspected prostate cancer, which then mandated use of biopsy for confirmation. 4 It kills over 3000 Australian men each year, which exceeds the number of women who die from breast cancer. Prostate cancer is the most frequently diagnosed solid malignant tumour in men.
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