Summary: | Prostate cancer is the third leading cause of cancer death in Canadian men. The lifetime risk of developing prostate cancer is estimated around 14.2%, while the risk of dying from this cancer is 3.7%. In most cases, prostate cancer grows slowly and most men die due to causes other than prostate cancer even before the cancer becomes clinically evident. Survival from prostate cancer depends largely on the progression of tumor at the time of diagnosis. The early detection of prostate cancer is believed to reduce the prostate cancer morbidity. However, earlier detection may also result in over-diagnosis and over-treatment of mild forms of prostate cancer; the treatment of such cancers might be more aggressive than the cancer itself. The debate over prostate cancer screening became more prominent by the introduction of the prostate-specific antigen (PSA) test for the detection of prostate cancer. The PSA testing was shown to be very sensitive, and has contributed the increase of prostate cancer incidence since 1990. Despite the wide adoption of PSA testing in prostate cancer screening, the evidence supporting its use still unclear. Several clinical guidelines have been developed to organize and orient prostate cancer screening programs. The objective of this review is to evaluate the quality of the North American guidelines on prostate cancer screening
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