PIVOT and the challenges of localized prostate cancer care

Putting it mildly, prostate cancer screening and treatment has been a contentious issue over the past year. With the recent US Preventative Services Task Force grade D recommendation to abandon routine PSA screening, pressing questions regarding the utility of populationwide PSA screening and the harms of overdiagnosis and overtreatment have continued to make national headlines. Determining whether PSA screening and subsequent treatment provides a survival benefit, in particular for men with low risk disease, has become of paramount concern to patients and urologists.