Screening for prostate cancer: growth without control.

In France, no official recommendations for or against systematic screening for prostate cancer have been issued yet. Therefore, individuals' choices with regard to screening or non-screening, and general practitioners' (GPs) recommendations for or against systematic screening should reflect personal preferences. Four nationwide observational studies (surveys) were conducted in France, two in 2005 and two in 2008, on a representative sample of participants aged between 40 and 75 years and a representative sample of GPs. In 2005, 36% of the male population interviewed, and aged between 50 and 75 years declared having undergone a screening test, compared with 49% in 2008 [odds ratio (OR)=1.63; 95% confidence interval (CI)=1.25-2.12]. In 2008, the number of men interviewed who reported having undergone screening less than 1 year earlier increased from 51% in 2005 to 74% (OR=2.18; 95% CI=1.40-3.40). The screening rate for young men (45-49 years) was only 7% in 2008 (data not available in 2005). In 2005, 58% of GPs systematically recommended prostate cancer screening for their patients aged 50-74 years, whereas in 2008, the figure was 65% (OR=1.32; 95% CI=1.04-1.66). The sex or age of the GPs had no significant impact on this rate. In France, we have observed a highly significant increase in prostate cancer screening: more men are screened, more often, at a younger age and more frequently using a prostate-specific antigen blood test. In our surveys, the observed threshold age for onset of prostate cancer screening is 50 years, almost the same as that for approved organized breast and colorectal screening programmes.