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New PSA-Based Screening Tests for Prostate Cancer

Nariman Malik, BSc

Introduction
Prostate cancer is the most frequently diagnosed cancer in Canadian men,1 and is the second leading cause of death due to cancer among North American men, just after lung cancer.3 In the early nineties, the number of prostate cancer cases diagnosed increased dramatically. By 1995, the incidence had peaked and has since leveled off in both Canada and the United States. In 1999, it was estimated that there would be approximately 16,600 new cases of prostate cancer in Canada.2 This increase can be at least partially attributed to newer methods for detecting the disease earlier, particularly since the introduction of routine serum prostate specific antigen (PSA) testing in the early 1990s.1

The risk of developing prostate cancer increases with age. Sixty to seventy-five percent of cancers are diagnosed in men who are over 65 years of age.3 Because of Canada's aging population, primary care physicians will see an increasing number of prostate cancer cases in their practices. It is, therefore, of utmost importance that physicians dealing with the elderly have a clear understanding of the various aspects of this disease. This article focuses on these various aspects of prostate cancer: risk factors, screening techniques, diagnosis and treatment modalities.