Dale,

Here's an article from the US National Cancer Institute: http://www.webmd.com/prostate-cancer/news/20090318/new-debate-on-prostate-cancer-screening

As you can see, they focus on "survival." This is a good example of the "quality years of life" issue I talked about. Mortality adds to 100% in the end so it would be a mistake to require the health service to drive down mortality rates in every area, because it still has to add up to the same in the end. That sort of thinking leads to heroic but ultimately counterproductive efforts towards the end of somebody's natural term. The goal of the health service is not to juggle percentages but to improve quality of life in a cost-effective manner that makes sense. The way to see prostate screening across the board is not to discuss mortality but to quantify the life impacts of catching the disease early. IMHO anyway.

One topic that does matter is the number of people who require treatment after screening to save one life. In the case of breast cancer, it's 10 women needing treatment after screening to save one life. In the European study of prostate it's about 50 men needing treatment after screening to save one life. The challenge is to be sure that one of those men isn't the example I gave elsewhere, somebody who never really recovers and dies in hospital. In that case you've saved one life but you've also ended one early. If it is true that men with prostate tend to be older, what if it actually "costs" 2 or 3 lives to "save" one? This does not show in the cancer mortality figures but it is something that deserves responsible consideration.