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For nearly three quarters of a century, it has been recognized that more than 30 percent of men over 50 years of age harbor a latent form of prostatic adenocarcinoma that is detected only on postmortem examination. Yet the rates of detection in populations of men screened with digital rectal examination, measurement of serum prostate-specific antigen, or both are only 1 to 5 percent. Still, clinically detected prostate cancer is the most common noncutaneous cancer in American men and the third most common cancer in men worldwide. Many men with prostate cancer die with this neoplasm rather than of it,
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