Prostate cancer has been described as the par excellence example of overdiagnosis. This does not mean that there are not men whose lives are saved from early death from prostate cancer by early diagnosis. But . . . we have little way of knowing in advance which men will benefit from screening and which will be unnecessarily treated, often with serious adverse consequences to their life. The fundamental problem is that by screening and testing for prostate cancer we are finding many more prostate cancers than we ever did before, and strange as it may seem, many of these cancers would never become life threatening.
In the past these men would never have known they had prostate cancer, they would go on to die of something else, dying with their prostate cancer, rather than because of it. By finding all these prostate cancers that are indolent we are giving many more men a prostate cancer diagnosis than ever before. Hence the term “overdiagnosis”. This is the core dilemma that each man contemplating being tested faces.