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Correspondence
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Volume 334:666-668 March 7, 1996 Number 10
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Screening for Prostate Cancer

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 by Woolf, S. H.
To the Editor: Woolf's review (Nov. 23 issue)1 of screening for cancer with prostate-specific antigen (PSA) omits important findings. He states that PSA testing could cost billions of dollars but does not mention that treating advanced prostate cancer is far more costly than treating early disease.

Woolf questions the importance of the spread of cancer beyond the prostate gland because extraprostatic extension has been reported in autopsy studies; however, the spread of cancer is associated with bad outcomes.2 Findings in autopsy series are not representative of those in the general population. It cannot be assumed that a tumor with adverse . . . [Full Text of this Article]

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