David C Miller BS David K Ornstein MD Gerald L Andriole MD

Prostate cancer is the most commonly diagnosed noncuta-neous malignancy in American men and is exceeded only by lung cancer as a cause of cancer death among United States males.1 Estimates for 1998 indicated that over 180,000 men would be diagnosed with carcinoma of the prostate in the United States and more than 39,000 would die from this disease.1 In addition, a substantial fraction of United States health care dollars are allocated to diagnosis and treatment of this disease.2 The identification of serum prostate-specific antigen (PSA) measurements as a valuable tool for early diagnosis of prostate cancer has resulted in widespread implementation of early detection as a means to reduce the morbidity and mortality of this cancer. The importance of improving diagnosis and treatment for men with prostate cancer is unchallenged; however, the most efficient way of accomplishing this has been debated.

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