Brawley OW – While prostate cancer remains largely a disease diagnosed in older men, screening has increased risk of diagnosis among men in their 40s and 50s. The incidence rates and 5–year survival rates are heavily influenced by the introduction of serum prostate–specific antigen (PSA) and widespread screening. The effects of PSA usage and screening on mortality rates are less certain. Outcome studies among men treated with radical prostatectomy show that greater than 30% relapse rates are common. This suggests that many men who are diagnosed with “localized early stage disease” actually have “apparently localized early stage disease,” which is really low volume metastatic disease.
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