The dilemmas of prostate cancer screening

To the Editor: Recent articles in the Journal reflect the continuing polarisation of the debate on prostate-specific antigen-based screening and the extent to which major clinical trials reveal whether lives are saved by intervention and/or watchful waiting.1,2All clinical trials have limitations, and the ERSPC (European Randomized Study of Screening for Prostate Cancer)3 and the United States PLCO (Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial) are no exception.3 ,4 The calls by two senior authors of the ERSPC trial to evaluate only high-quality studies and to avoid pooling heterogeneous data are commendable.1 However, to then argue that only their trial satisfies these criteria is scientifically questionable, since this multi-country trial is compromised precisely by this action.