Department of Urology, Erasmus MC, University Medical Centre, PO Box 2040, 3000 CA Rotterdam, the Netherlands.
Asian J Androl. 2011 Mar;13(2):219-24. doi: 10.1038/aja.2010.180. Epub 2011 Feb 7.
Since the first publication describing the identification of prostate-specific antigen (PSA) in the 1960s, much progress has been made. The PSA test changed from being initially a monitoring tool to being also used as a diagnostic tool. Over time, the test has been heavily debated due to its lack of sensitivity and specificity. However, up to now the PSA test is still the only biomarker for the detection and monitoring of prostate cancer. PSA-based screening for prostate cancer is associated with a high proportion of unnecessary testing and overdiagnosis with subsequent overtreatment. In the early years of screening for prostate cancer, high rates of uptake were very important. However, over time the opinion on PSA-based screening has shifted towards the notion of informed choice. Nowadays, it is thought to be unethical to screen men without them being aware of the pros and cons of PSA testing, as well as the fact that an informed choice is related to better patient outcomes. Now, as the results of three major screening studies have been presented and the downsides of screening are becoming better understood, informed choice is becoming more relevant.
自 20 世纪 60 年代首次描述前列腺特异性抗原（PSA）的鉴定以来，已经取得了许多进展。PSA 检测最初是一种监测工具，后来也被用作诊断工具。随着时间的推移，由于其缺乏敏感性和特异性，该检测受到了广泛的争议。然而，到目前为止，PSA 检测仍然是检测和监测前列腺癌的唯一生物标志物。基于 PSA 的前列腺癌筛查与大量不必要的检测和过度诊断以及随后的过度治疗有关。在前列腺癌筛查的早期，高吸收率非常重要。然而，随着时间的推移，人们对基于 PSA 的筛查的看法已经转向知情选择的概念。如今，如果不告知男性 PSA 检测的利弊，以及知情选择与更好的患者结局有关，那么对男性进行筛查被认为是不道德的。现在，随着三项主要筛查研究的结果公布，以及对筛查弊端的认识不断加深，知情选择变得更加相关。
