The dilemmas of prostate cancer screening

To the Editor: We are concerned by conclusions drawn by Del Mar and colleagues,1 in stating that because some autopsy studies have claimed more than 50% prevalence of latent prostate cancer in men aged over 60 years, this could be considered normal, and that these latent cancers result in a high level of overdiagnosis of prostate cancer. The study cited was conducted at Wayne State University, Detroit, in the early 1990s and indeed showed that as many as 70% of African American men in that age group showed latent prostate cancer.2 However, other articles relating to these data show that the lesions were very small, on average less than 2.3 mm, and were of a very low grade, mainly with a Gleason score of 2–5.3,4