• 1
    Smith RA, Von Eschenbach AC, Wender R. American Cancer Society guidelines for the early detection of cancer. Update of early detection guidelines for prostate, colorectal, and endometrial cancers. CA Cancer J Clin 2001; 51: 3844
  • 2
    Carroll P, Coley C, McLeod D et al. Prostate-specific antigen best practice policy – Part I. Early detection and diagnosis of prostate cancer. Urology 2000; 57: 21724
  • 3
    Preventive Services Task Force. Guide to Clinical Preventive Services, 2nd edn. Baltimore: Williams & Wilkins, 1995
  • 4
    Canadian Task Force on the Periodic Health Examination. The Canadian guide to clinical preventive health care. Ottawa, Ont: Canada Communication Group, 1994
  • 5
    Hicks HJ, Hamm RM, Bemden DA. Prostate cancer screening: what family physicians believe is best. Arch Fam Med 1995; 4: 31722
  • 6
    Schröder FH, Van Der Maas P, Beemsterboer PMM et al. Evaluation of digital rectal examination as a screening test for prostate cancer. J Natl Cancer Inst 1998; 90: 181723
  • 7
    Schröder FH. Re: Lest we abandon digital rectal examination as a screening test for prostate cancer. J Natl Cancer Inst 1999; 91: 13312
  • 8
    Vis AN, Hoedemaeker RF, Roobol M et al. Tumor characteristics in screening for prostate cancer with and without rectal examination as an initial screening test at low PSA (0.0–3.9 ng/ml). Prostate 2001; 47: 25261
  • 9
    Smith DS, Catalona WJ. Interexaminer variability of digital rectal examination in detecting prostate cancer. Urology 1995; 45: 704
  • 10
    Basler JW, Thompson IM. Lest we abandon digital rectal examination as a screening test for prostate cancer. J Natl Cancer Inst 1998; 90: 17613
  • 11
    Carvalhal GF, Smith DS, Mager DE et al. Digital rectal examination for detecting prostate cancer at prostate-specific antigen levels of 4 ng/ml or less. J Urol 1999; 161: 8359
  • 12
    McNaughton Collins M, Ransohoff DF, Barry MJ. Early detection of prostate cancer. Serendipity strikes again. JAMA 1997; 278: 15169
  • 13
    Beemsterboer PMM, De Koning HJ, Kranse R et al. Changing role of three screening modalities in the European Randomized Study of Screening for Prostate Cancer (Rotterdam). Int J Cancer 1999; 84: 43741DOI: 10.1002/(sici)1097-0215(19990820)84:4<437::aid-ijc19>;2-s
  • 14
    Kranse R, Beemsterboer PMM, Rietbergen J et al. Predictors for biopsy outcome in the European Randomized Study of Screening for Prostate Cancer (Rotterdam region). Prostate 1999; 39: 31622DOI: 10.1002/(sici)1097-0045(19990601)39:4<316::aid-pros14>;2-o
  • 15
    Schröder FH, Van Der Cruijssen-Koeter I, De Koning HJ et al. Prostate cancer detection at low prostate specific antigen. J Urol 2000; 163: 80612
  • 16
    Rietbergen JBW, Boeken Kruger AE, Hoedemaeker RF et al. Repeat screening for prostate cancer after 1-year followup in 984 biopsied men. Clinical and pathological features of detected cancer. J Urol 1998; 160: 21215
  • 17
    Stamey TA, McNeal JE, Freiha FS et al. Morphometric and clinical studies on 68 consecutive radical prostatectomies. J Urol 1988; 139: 123541
  • 18
    Hoedemaeker RF, Ruijter ETG, Ruizeveld-de Winter JA et al. Processing radical prostatectomy specimens. J Urol Path 1998; 9: 21122
  • 19
    Hoedemaeker RF, Rietbergen JBW, Kranse R et al. Comparison of pathological characteristics of T1c and non-T1c cancers detected in a population-based screening study, the European Randomized Study of Screening for Prostate Cancer. World J Urol 1997; 15: 33945
  • 20
    Jacobsen SJ, Katusic SK, Bergstrahl EJ et al. Incidence of prostate cancer diagnosis in the era before and after serum prostate-specific antigen testing. JAMA 1995; 161: 14459
  • 21
    Flanigan RC, Catalona WJ, Richie JP et al. Accuracy of digital rectal examination and transrectal ultrasonography in localizing prostate cancer. J Urol 1994; 152: 15069
  • 22
    McNaughton Collins M, Barry MJ. Controversies in prostate cancer screening. Analogies to the early lung cancer screening debate. JAMA 1996; 276: 19769
  • 23
    The International Prostate Screening Trial Evaluation Group. Rational for randomized trials of prostate cancer screening. Eur J Cancer 1999; 35: 26271
  • 24
    De Koning HJ, Schröder FH. PSA screening for prostate cancer: The current controversy. Ann Oncol 1998; 9: 12936
  • 25
    Mettlin C, Lee F, Drago J et al. The American Cancer Society National Prostate Cancer Detection Project. Findings on the detection of early prostate cancer in 2,425 men. Cancer 1993; 67: 294958
  • 26
    Gustafsson O, Norming U, Almgard LE et al. Diagnostic methods in the detection of prostate cancer: a study of a randomly selected population of 2,400 men. J Urol 1992; 148: 182731
  • 27
    Colberg JW, Smith DS, Catalona WJ. Prevalence and pathological extent of prostate cancer in men with prostate-specific antigen levels of 2.9–4.0 ng/ml. J Urol 1993; 149: 5079
  • 28
    Lodding P, Aus G, Bergdahl S et al. Characteristics of screen detected prostate cancer in men 50–66 years old with 3–4 ng/ml prostate specific antigen. J Urol 1998; 159: 899903
  • 29
    Vis AN, Hoedemaeker RF, Roobol M et al. Defining a window of opportunity in screening for prostate cancer: validation of a predictive tumor classification model. Prostate 2001; 46: 15462
  • 30
    Epstein JI, Walsh PC, Carmichael M et al. Pathologic and clinical findings to predict tumor extent of nonpalpable (stage T1c) prostate cancer. JAMA 1994; 271: 36874
  • 31
    Goto Y, Ohori M, Arakawa A et al. Distinguishing clinically important from unimportant prostate cancers before treatment. Value of systematic biopsies. J Urol 1996; 156: 105963


  1. Authors

A.N. Vis, MD, Resident in Urology.

R. Kranse, BSc, Statistician.

M. Roobol, BSc, Datamanager ERSPC.

Th.H. van der Kwast, MD, PhD, Professor of Pathology.

F.H. Schröder, MD, PhD, Professor of Urology.


randomized controlled trial


European Randomized Study of Screening for Prostate Cancer


positive predictive value.