RT Journal
A1 Sanda MG, Kaplan ID
T1 PRostate cancer screening and surveillance—reply
JF JAMA
JO JAMA
YR 2009
FD October 14
VO 302
IS 14
SP 1529
OP 1530
DO 10.1001/jama.2009.1439
UL http://dx.doi.org/10.1001/jama.2009.1439
AB 
In Reply: Dr Rogers raises notable caveats regarding the clinical significance attributable to PSA screening observed in the ERSPC trial: improved survival associated with PSA screening (and consequent justifiable treatment of aggressive cancers) appears to come at the expense of overdiagnosis and overtreatment of low-risk cancers that have a potentially indolent clinical course. We acknowledge these limitations of PSA screening—and the burden this uncertainty brings to discussions between physicians and patients—in efforts to decide whether a man should undergo a PSA blood test and, if so, at what age and how frequently. As well-described in the Editorial1 that accompanied the ERSPC and PLCO trials, these studies represent laudable efforts but nevertheless have limitations that preclude them from providing a final resolution to the conundrum that mortality reduction from PSA screening is accompanied by overtreatment.