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前列腺特异性抗原大规模筛查:证据充分吗?

PSA mass screening: is there enough evidence?

作者信息

Rocco Bernardo, Grasso Angelica, Sosnowski Roman, Dell'orto Paolo Guido, Albo Giancarlo, Castle Erik, Coelho Rafael, Patel Vip, Mottrie Alex

机构信息

Department of Surgical Sciences, Section of Urology Specialist - University of Milan, Fondazione IRCCS Ospedale Maggiore Policlinico Granda of Urology Unit, Milan, Italy.

Urooncology Department, Maria Skłodowska-Curie, Memorial Cancer Hospital, Warsaw, Poland.

出版信息

Cent European J Urol. 2012;65(1):4-6. doi: 10.5173/ceju.2012.01.art1. Epub 2012 Mar 19.

Abstract

Prostate cancer plays an important role in widely understood aspects of men's health, and is becoming a growing problem in terms of public life. Prostate cancer is one of the most common neoplasms among men. Male patients can live with prostate cancer for a long time so it is important to offer appropriate males adequate diagnostic tools and treatments. Prostate cancer and PSA potentially represent a "pair" of a disease and an appropriate indicator to be used in mass screening, but regardless of that there is still active debate about it. Extensive use of PSA screening has modified epidemiology of the diseases. Randomized controlled studies provided sufficient results regarding a reduction in mortality through PSA mass screening, while all agreed on risks of overdiagnosis and overtreatment. New and accurate screening tools are necessary, along with adequate counseling and risk stratification.

摘要

前列腺癌在男性健康的广泛认知方面起着重要作用,并且在公共生活层面正成为一个日益严重的问题。前列腺癌是男性中最常见的肿瘤之一。男性患者可以长期携带前列腺癌,因此为合适的男性提供足够的诊断工具和治疗方法很重要。前列腺癌和前列腺特异性抗原(PSA)可能代表了一种疾病和一种适用于大规模筛查的指标“组合”,但尽管如此,关于它仍存在激烈的争论。PSA筛查的广泛应用改变了该疾病的流行病学。随机对照研究提供了关于通过PSA大规模筛查降低死亡率的充分结果,同时所有人都认同过度诊断和过度治疗的风险。新的、准确的筛查工具以及充分的咨询和风险分层是必要的。

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