Junod A F
Medizinischen Fakultät Genf.
Praxis (Bern 1994). 2005 Sep 28;94(39):1525-9. doi: 10.1024/0369-8394.94.39.1525.
Screening of prostate cancer with PSA is a challenge for the aid to decision. Beside the rather mediocre characteristics of the screening test, there the additional problem of the peculiar biology of this cancer, with its late development and its ability to remain latent for a prolonged period. On the other hand, the treatment (surgery, irradiation) is associated with important side-effects: impotence and urinary leakage. Several studies, which appear to be a form of aid to information than aid to shared decision, have been carried out to analyse the effect of various modes of information on the behaviour of potential candidates to screening of prostate cancer, with the following results: better knowledge of the problem, lower rate of acceptance of PSA testing and trend towards watchful waiting rather than surgery in case of discovery of cancer.
使用前列腺特异性抗原(PSA)筛查前列腺癌对辅助决策来说是一项挑战。除了筛查测试本身相当一般的特性外,这种癌症独特的生物学特性还带来了额外问题,其发展较晚且有长时间保持潜伏状态的能力。另一方面,治疗(手术、放疗)会带来严重的副作用:阳痿和尿失禁。已经开展了多项研究来分析不同信息模式对前列腺癌筛查潜在对象行为的影响,这些研究似乎更像是一种信息提供而非辅助共同决策,结果如下:对问题有了更好的了解,PSA检测的接受率降低,并且在发现癌症时倾向于密切观察而非手术。