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对美国预防服务工作组关于前列腺癌筛查的决策的回应。

Response to the U.S. Preventative Services Task Force decision on prostate cancer screening.

机构信息

Center for Urologic Oncology, Glickman Urological & Kidney Institute, Cleveland Clinic, 9500 Euclid Avenue, Desk Q10-1, Cleveland, OH 44195, USA.

出版信息

Curr Urol Rep. 2013 Jun;14(3):168-73. doi: 10.1007/s11934-013-0318-9.

Abstract

The population-level data demonstrate that the inception of prostate-specific antigen (PSA) screening has lowered mortality for prostate cancer over the past 2 decades. However, more recent evidence from randomized trials has presented conflicting results regarding the benefit of PSA screening for prostate cancer mortality. Using available data, the U.S. Preventative Services Task Force recently recommended against PSA screening for prostate cancer. However, prostate cancer continues to kill over 30,000 men annually, and as such, completely abandoning screening for this disease is a disservice to many patients. Rather, the emphasis should be on utilizing evidence-based medicine to reduce overdiagnosis and overtreatment through less frequent screening for low-risk individuals or those unlikely to benefit from screening, halting further screening when appropriate, and utilizing observational strategies in patients unlikely to suffer clinically significant effects of prostate cancer over their anticipated life expectancy.

摘要

人群水平数据表明,在过去的 20 年中,前列腺特异性抗原(PSA)筛查的出现降低了前列腺癌的死亡率。然而,最近来自随机试验的证据对 PSA 筛查前列腺癌死亡率的益处提出了相互矛盾的结果。利用现有数据,美国预防服务工作组最近建议不要对前列腺癌进行 PSA 筛查。然而,前列腺癌每年仍导致超过 30000 名男性死亡,因此,完全放弃对这种疾病的筛查对许多患者是不利的。相反,应该强调利用循证医学,通过对低危人群或不太可能从筛查中获益的人群减少筛查频率,在适当的时候停止进一步筛查,以及在不太可能因预期寿命而遭受前列腺癌临床显著影响的患者中利用观察策略,来减少过度诊断和过度治疗。

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