Prostate cancer screening and bacteraemia

To the Editor: Prostate cancer screening remains controversial. There is currently a lack of evidence that treating prostate cancers identified by screening leads to prolonged survival,1 and the main screening test (serum prostate-specific antigen [PSA] concentration) has poor sensitivity and specificity. Patients with an elevated PSA level usually undergo a transrectal ultrasound-guided (TRUS) prostate biopsy for definitive diagnosis. TRUS biopsy is associated with risks that include bleeding, urinary tract infections, prostatitis and bacteraemia. Infective complications can occur even when prophylactic antibiotics are administered.2 Gram-negative bacteraemia is usually associated with a mortality rate of at least 5%.3