Division of Urology, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030-3955, USA.
Med Clin North Am. 2011 Jan;95(1):191-200. doi: 10.1016/j.mcna.2010.08.024.
Since the introduction of prostate-specific antigen (PSA) screening in the late 1980s, more prostate cancers have been detected, and at an earlier stage. As a consequence, the majority of prostate cancers are now detected years before the emergence of clinically evident disease, which usually represents locally advanced or metastatic cancer. PSA screening has remained controversial, because many of the prostate cancers detected are low grade and slow growing. With this long natural history and a median survival without treatment that often approaches at least 15 to 20 years, many clinicians and researchers have questioned if prostate cancer screening and treatment actually improves survival, as many patients will die with prostate cancer rather than of prostate cancer. In this review, the authors discuss the rationale for prostate cancer screening and present the current guidelines for the use of PSA.
自 20 世纪 80 年代末引入前列腺特异性抗原（PSA）筛查以来，更多的前列腺癌被发现，且处于更早的阶段。因此，大多数前列腺癌现在在临床上明显疾病出现之前的几年就被检测到，而临床上明显疾病通常代表局部晚期或转移性癌症。PSA 筛查一直存在争议，因为许多被检测到的前列腺癌分级较低且生长缓慢。鉴于这种漫长的自然病史和中位无治疗生存期通常接近至少 15 到 20 年，许多临床医生和研究人员质疑前列腺癌筛查和治疗是否真的能改善生存，因为许多患者会死于与前列腺癌无关的其他疾病，而非死于前列腺癌。在这篇综述中，作者讨论了前列腺癌筛查的基本原理，并介绍了目前 PSA 使用的指南。
