Hoffman Azik, Half Elizabeth E
Division of Urology, Department of Surgical Oncology, Princess Margaret Hospital, Toronto, ON, Canada.
Department of Gastroenterology, Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa Israel.
Rambam Maimonides Med J. 2017 Oct 16;8(4):e0041. doi: 10.5041/RMMJ.10318.
Urological malignancies are a major source of morbidity and mortality in men over 40. Screening for those malignancies has a potential benefit of reducing both. However, even after more than two decades of screening for prostate cancer, the implications of most resulting information are still a matter of debate. Controversy extends over several aspects of prostate cancer screening programs, including age of onset, defining populations at risk, most appropriate intervals, as well as the optimal methods to be used for screening. The medical community is still divided regarding the effectiveness of prostate cancer-related death prevention and its benefits-to-harms ratio, reflecting an inconsistency regarding screening recommendations. Similarly, benefits of screening for urothelial and kidney tumors are yet lacking high-level evidence, although recent evidence supports screening of populations at risk. Clearly, the current era of evolving molecular and genetic biomarkers harbors the potential to change screening practice. In this paper, we review current guidelines as well as giving an update on new developments which might influence screening strategies in common urological malignancies.
泌尿系统恶性肿瘤是40岁以上男性发病和死亡的主要原因。对这些恶性肿瘤进行筛查可能会降低发病率和死亡率。然而，即使经过二十多年的前列腺癌筛查，大多数所得信息的意义仍存在争议。争议涉及前列腺癌筛查计划的多个方面，包括发病年龄、确定高危人群、最合适的筛查间隔以及用于筛查的最佳方法。医学界在前列腺癌相关死亡预防的有效性及其利弊比方面仍存在分歧，这反映了筛查建议的不一致性。同样，尽管最近的证据支持对高危人群进行筛查，但尿路上皮肿瘤和肾肿瘤筛查的益处仍缺乏高级别证据。显然，当前不断发展的分子和遗传生物标志物时代具有改变筛查实践的潜力。在本文中，我们回顾了当前的指南，并介绍了可能影响常见泌尿系统恶性肿瘤筛查策略的新进展。
