De Vrieze Maxime, Al-Monajjed Rouvier, Boschheidgen Matthias, Albers Peter
Division of Personalized Early Detection of Prostate Cancer, German Cancer Research Center (DKFZ), D-69120 Heidelberg, Germany.
Department of Urology, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, Germany.
J Pers Med. 2024 Jul 31;14(8):818. doi: 10.3390/jpm14080818.
Prostate cancer (PCa) screening strategies are being developed and evaluated in several countries. However, most of the evidence regarding PCa screening has been generated in study populations aged 50 and older. This study summarizes findings of a screening trial in younger men and discuss those findings in the context of other screening trials. Non-systematic review. Screening of 45-year-old men resulted in a low PCa detection rate. Nonetheless, almost 70% of screen-detected PCa at this age was clinically significant. In young men ISUP GG 1 screen-detected cancers warrant rigorous follow-up. A baseline, midlife prostate-specific antigen (PSA) value at age 45 may safely exclude the vast majority of men from further screening investigations for at least 5 years. At age 45, a confirmatory PSA value reduces the number of subsequent tests almost by half. Sequential magnetic resonance imaging (MRI) as a reflex test subsequent to an elevated PSA ≥ 3 ng/mL needs further investigation in young men. Screening in young men needs to be carefully investigated in order to avoid overscreening and overdiagnosis.
前列腺癌(PCa)筛查策略正在多个国家制定和评估中。然而,大多数关于PCa筛查的证据是在50岁及以上的研究人群中产生的。本研究总结了一项针对年轻男性的筛查试验结果,并结合其他筛查试验对这些结果进行了讨论。非系统性综述。对45岁男性进行筛查的前列腺癌检出率较低。尽管如此,这个年龄段通过筛查发现的PCa中,近70%具有临床意义。在年轻男性中,国际泌尿病理学会(ISUP)分级为1级的筛查发现的癌症需要严格随访。45岁时的基线、中年前列腺特异性抗原(PSA)值可以安全地排除绝大多数男性至少5年的进一步筛查调查。在45岁时,一个确认性的PSA值可使后续检查次数几乎减少一半。对于PSA≥3 ng/mL升高后作为反射性检查的序贯磁共振成像(MRI),在年轻男性中需要进一步研究。为避免过度筛查和过度诊断,需要对年轻男性的筛查进行仔细研究。