Screening for prostate cancer - The challenge of promoting informed decision making in the absence of definitive evidence of effectiveness

Evidence demonstrating the burden of prostate cancer upon men in the United States is incontrovertible; less compelling however, is proof of benefit from early detection efforts. Nevertheless, the absence of definitive evidence does not lessen the interest of men in prostate testing or the obligation of physicians to help interested men make well-informed decisions, which integrate personal circumstance and preference with the best available data. This article provides the counseling physician with the information required to frame the current prostate testing debate and an approach to support informed decision making by men who can benefit from their assistance.