Screening With Prostate-Specific Antigen: Should We or Shouldn't We?-Reply

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In Reply. —In my Editorial, I stated that if the tradition of a periodic prostate examination is to be continued, it now must include a serum prostate-specific antigen concentration and a digital rectal examination, and that the survival benefit of this examination is not yet proven but should be tested in randomized trials which are about to begin but will take more than 10 years to complete. Nonetheless, I recommended continued advocacy of the periodic prostate examination for now, although not necessarily its logical extension, screening. Dr Herbers chooses to differ; he aligns himself with the school of thought that believes that preventive examinations should include only what is definitely proven beneficial. This strategy is logical and preferable to many thoughtful physicians, especially those who are preoccupied with major preoccupation is cost-benefit ratios. I discussed reasons why a position in favor of the periodic prostatic examination is also logical. Briefly,

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