Prostate cancer in Jamaica and the wider Caribbean: it is time to consider screening

Prostate cancer (PCa) is the second most frequently diagnosed cancer in the world (1) and the leading cancer affecting men in Jamaica (2). If PCa is identified early in its natural history, it is eminently treatable with great potential for cure. The Caribbean has the highest age standardized PCa-specific mortality rates in the world (1). Why is this so and what can be done to reduce the morbidity and mortality associated with PCa in the Caribbean? Prostate cancer has a variable natural history ranging from slowly growing indolent cancers at one end of the spectrum to aggressive cancers with high Gleason scores at the other end. Early disease is usually asymptomatic but detectable by screening methods. To date, most cancers in Jamaica are identified after symptoms appear (3). This paper examines the role of screening and argues for increased screening in the population.