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[前列腺癌筛查:2024年是否应被推荐?]

[Prostate cancer screening : to be recommended in 2024?].

作者信息

Bosshart Alexandrine, Bacchetta Frédéric, Boesch Anne, Durand Marie-Anne, Valerio Massimo, Selby Kevin

机构信息

Unisanté, Centre universitaire de médecine générale et santé publique, 1011 Lausanne.

Service d'urologie, Centre hospitalier universitaire vaudois, 1005 Lausanne.

出版信息

Rev Med Suisse. 2024 Nov 6;20(894):2043-2047. doi: 10.53738/REVMED.2024.20.894.2043.

Abstract

The Prostate Specific Antigen (PSA) blood test is still the only screening tool for prostate cancer. It is recommended between the ages of 50 and 69 as part of a shared decision making process between a patient and his or her doctor using a decision aid, as the test carries a significant risk of overdiagnosis. If a patient wishes to be screened, either because he is at higher risk, or because he places greater importance on a modest reduction in cancer-related mortality, the frequency of screening depends on his age, family history, and whether he is part of a high-risk group. The use of multiparametric MRI after a positive PSA result can reduce the number of biopsies and, consequently, the risk of overdiagnosis.

摘要

前列腺特异性抗原(PSA)血液检测仍是前列腺癌唯一的筛查工具。建议在50至69岁之间进行该检测,这是患者与其医生之间通过决策辅助工具共同做出决策过程的一部分,因为该检测存在过度诊断的重大风险。如果患者希望接受筛查,要么是因为他处于较高风险,要么是因为他更重视癌症相关死亡率的适度降低,那么筛查频率取决于他的年龄、家族史以及他是否属于高危人群。PSA检测结果呈阳性后使用多参数MRI可以减少活检次数,从而降低过度诊断的风险。

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