Is a single screening round sufficient to detect all high-risk prostate cancers?—lessons learned from the European Randomized Study of Screening for Prostate Cancer Study

The widespread availability of PSA testing in the late 80s to early 90s subsequently led to questions being asked regarding its suitability in mass screening for the early detection of prostate cancer (PC). The low specificity of PSA for PC in the lower PSA ranges has resulted in over-investigation, and over-diagnosis of indolent cancers, leading to a scenario where the burden of cure frequently exceeded the burden of the disease if left untreated.