What has changed in the epidemiology and screening of prostate cancer?

OBJECTIVE: The objective of this study is to review the evolution and changes of prostate cancer epidemiology and to perform an analysis of the current status of prostate cancer screening based on the various studies and scientific societies recommendations. METHODS: We performed a bibliographic review of relevant papers in relation to prostate cancer epidemiology and screening, with special focus on international and multicentric trials on population screening. RESULTS: The current number and profile of patients being diagnosed of prostate cancer have changed significantly from the pre-PSA era to the present time. Early diagnosis and screening strategies have caused an increase in incidence and a decrease in cancer mortality in some countries. CONCLUSIONS: Systematic screening, despite inconsistencies in some studies, seems to improve prostate cancer specific mortality. The introduction of new biomarkers, imaging techniques such as mpMRI as well as less aggressive therapeutic alternatives, probably open windows to the future for a better diagnosis and treatment of the disease.