PSA Screening and Prostate Cancer Incidence-Reply

In Reply. —We agree with the comments from Drs Rhoads and Mills regarding the lack of data in our article that demonstrate a reduction in morbidity and mortality from prostate cancer. However, their assertion that the transient increase in incidence of prostate caner will not be short lived is perhaps too globally stated. The duration of the increase is a function of the incidence and prevalence of cancer and it also depends on the degree of penetration of screening programs. In Olmsted County, Minnesota, where the rates of serum PSA testing have reached 50% of the population of men in their 60s, the transient increase will be much shorter lived than in areas where only 10% to 20% of the population is screened each year. Rhoads and Mills are also correct in focusing on mortality as one of the ultimate measures of efficacy of the screening program. We hope that