Adv Clin Chem. 2014;66:1-23.
The aim of screening for prostate cancer is to detect malignancy at an early and potentially treatable stage, thereby increasing the chance of cure. Although serum PSA has been used as a screening test for prostate cancer for over 20 years, the practice is controversial. As a screening test for prostate cancer, PSA lacks sensitivity and specificity for early disease. Furthermore, screening may lead to unnecessary biopsies, overdetection, and overtreatment. It is thus unclear whether the benefits of screening outweigh the harms. Although published guidelines differ in their recommendation for PSA screening, almost all state that prior to PSA testing, men should be informed of the risks and benefits of the process. Most guidelines also state that men with a life expectancy of less than 10 years should not be screened. New markers currently undergoing evaluation such as -2proPSA, Prostate Health Index, and PCA3 may complement PSA in the detection of early prostate cancer.
前列腺癌筛查的目的是在早期发现并可能治疗恶性肿瘤，从而增加治愈的机会。尽管血清 PSA 已被用作前列腺癌筛查测试超过 20 年，但这种做法仍存在争议。作为前列腺癌的筛查测试，PSA 对早期疾病的敏感性和特异性不足。此外，筛查可能导致不必要的活检、过度检测和过度治疗。因此，尚不清楚筛查的益处是否超过危害。尽管已发布的指南在 PSA 筛查的推荐方面存在差异，但几乎所有指南都指出，在进行 PSA 检测之前，应告知男性该过程的风险和益处。大多数指南还指出，预期寿命不足 10 年的男性不应进行筛查。目前正在评估的新标志物，如 -2proPSA、前列腺健康指数和 PCA3，可能会在检测早期前列腺癌方面补充 PSA。
