Moghul Masood, Cazzaniga Walter, Croft Fionnuala, Kinsella Netty, Cahill Declan, James Nicholas David
Department of Urology, The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK.
Division of Radiotherapy and Imaging, The Institute of Cancer Research, London SW3 6JB, UK.
Clin Pract. 2023 Jul 28;13(4):863-872. doi: 10.3390/clinpract13040078.
Prostate cancer, the most common cause of cancer in men in the UK and one of the most common around the world to date, has no consensus on screening. Multiple large-scale trials from around the world have produced conflicting outcomes in cancer-specific and overall mortality. A main part of the issue is the PSA test, which has a high degree of variability, making it challenging to set PSA thresholds, as well as limited specificity. Prostate cancer has a predisposition in men from black backgrounds, and outcomes are worse in men of lower socioeconomic groups. Mobile targeted case finding, focusing on high-risk groups, may be a solution to help those that most need it. The aim of this systematic review was to review the evidence for mobile testing for prostate cancer. A review of all mobile screening studies for prostate cancer was performed in accordance with the Cochrane guidelines and the PRISMA statement. Of the 629 unique studies screened, 6 were found to be eligible for the review. The studies dated from 1973 to 2017 and came from four different continents, with around 30,275 men being screened for prostate cancer. Detection rates varied from 0.6% in the earliest study to 8.2% in the latest study. The challenge of early diagnosis of potentially lethal prostate cancer remains an issue for developed and low- and middle-income countries alike. Although further studies are needed, mobile screening of a targeted population with streamlined investigation and referral pathways combined with raising awareness in those communities may help make the case for screening for prostate cancer.
前列腺癌是英国男性最常见的癌症病因,也是迄今为止全球最常见的癌症之一,目前在筛查方面尚无共识。世界各地的多项大规模试验在癌症特异性死亡率和总死亡率方面产生了相互矛盾的结果。问题的主要部分在于前列腺特异性抗原(PSA)检测,其具有高度变异性,这使得设定PSA阈值具有挑战性,而且特异性有限。前列腺癌在黑人男性中更易发病,社会经济地位较低的男性患者预后更差。针对高危人群的移动靶向病例发现可能是帮助最需要者的一种解决方案。本系统评价的目的是回顾前列腺癌移动检测的证据。根据Cochrane指南和PRISMA声明对所有前列腺癌移动筛查研究进行了综述。在筛选的629项独特研究中,发现6项符合综述要求。这些研究的时间跨度从1973年至2017年,来自四大洲,约30275名男性接受了前列腺癌筛查。检测率从最早研究中的0.6%到最新研究中的8.2%不等。对潜在致命性前列腺癌进行早期诊断的挑战,无论是在发达国家还是在低收入和中等收入国家,仍然是一个问题。尽管还需要进一步研究,但对目标人群进行移动筛查,结合简化的检查和转诊途径,并提高这些社区的认识,可能有助于为前列腺癌筛查提供依据。