Gohagan J K, Prorok P C, Kramer B S, Cornett J E
Division of Cancer Prevention and Control, National Cancer Institute, National Institutes of Health, Bethesda, Maryland.
J Urol. 1994 Nov;152(5 Pt 2):1905-9. doi: 10.1016/s0022-5347(17)32412-6.
Screening for prostate cancer and subsequent treatment is of unknown benefit but carries known treatment related morbidity and mortality risks. The recent enthusiasm for screening in the United States contrasts sharply with the more cautious attitudes of the European and Canadian medical communities. Current data from screening series without randomization and controls are inadequate to determine screening benefit. The prostate, lung, colorectal and ovarian cancer (randomized, controlled) screening trial of the National Cancer Institute, to include 74,000 men (and 74,000 women) 60 to 74 years old, has a design power of 90% to determine a 20% reduction of prostate cancer mortality from a baseline and 3 subsequent annual screens using prostate specific antigen and digital rectal examination. Randomization of participants into this trial began on November 16, 1993. Ten screening centers nationwide, a coordinating center, a laboratory and a biorepository are participating under contract.
前列腺癌筛查及后续治疗的益处尚不清楚,但已知存在与治疗相关的发病和死亡风险。美国近期对筛查的热情与欧洲和加拿大医学界更为谨慎的态度形成鲜明对比。目前来自无随机分组和对照的筛查系列的数据不足以确定筛查的益处。美国国立癌症研究所的前列腺、肺、结肠直肠和卵巢癌(随机、对照)筛查试验,将纳入74000名60至74岁的男性(以及74000名女性),其设计效能为90%,以确定通过使用前列腺特异性抗原和直肠指检,在基线及随后3次年度筛查后前列腺癌死亡率降低20%。该试验的参与者随机分组于1993年11月16日开始。全国十个筛查中心、一个协调中心、一个实验室和一个生物样本库正在根据合同参与。