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The appropriate treatment of prostate cancer continues to challenge researchers and clinicians. During the past decade, intensive screening for prostate-specific antigen has resulted in a dramatic rise in the number of cases that are diagnosed in the United States and Canada. As a result of this screening, most men who are diagnosed with prostate cancer in North America present with disease that is localized to the prostate. Testing for prostate-specific antigen has also increased in Europe, but to a much lesser degree. Many European governments do not support screening for prostate cancer as a public health policy. As a consequence,
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