Refining treatment for the men who need it: lessons from the PIVOT trial

The diagnosis and management of asymptomatic prostate cancer (PC) are complex issues in the midst of several controversies and conflicting recommendations. Largely due to the results of two large PSA screening trials showing an unclear benefit of PSA screening on overall patient survival, the US PSTF has recommended against its routine use (1). If implemented, this policy would drastically reduce the number of organ-confined PC diagnosed.