Budenholzer B R
Division of Clinical Enhancement and Development, Group Health Northwest, Spokane, Washington 99204-0204, USA.
J Fam Pract. 1995 Sep;41(3):270-8.
Prostate cancer is a common cause of cancer-related morbidity and mortality in men. Prostate-specific antigen (PSA) measurement to screen for prostate cancer has been promoted as a way to reduce morbidity and mortality from prostate cancer. This paper examines the usefulness of PSA screening for asymptomatic prostate cancer, focusing on outcomes for all patients screened. The sensitivity and specificity of PSA testing for prostate cancer are low and have not been studied properly in asymptomatic men being screened for prostate cancer. PSA screening detects localized prostate cancer undetected by digital rectal examination in fewer than 1% of men screened. The effectiveness of early treatment of prostate cancer, compared with deferral of treatment until symptoms develop, is unproven, and good survival rates have been reported among patients who defer aggressive treatment. Complications of treating prostate cancer with radical prostatectomy or radiation treatment include death, impotence, urethral stricture, incontinence, and rectal injury. At the present time, there is insufficient evidence to support a policy of PSA screening, and its use should be discouraged until randomized controlled trials demonstrate benefit from PSA screening.
前列腺癌是男性癌症相关发病和死亡的常见原因。前列腺特异性抗原（PSA）检测用于筛查前列腺癌，已被推广为降低前列腺癌发病和死亡的一种方法。本文探讨了PSA筛查无症状前列腺癌的效用，重点关注所有接受筛查患者的结果。PSA检测前列腺癌的敏感性和特异性较低，且在筛查无症状男性前列腺癌方面尚未得到恰当研究。PSA筛查在不到1%的受筛查男性中检测出直肠指检未发现的局限性前列腺癌。与推迟治疗直至出现症状相比，前列腺癌早期治疗的有效性尚未得到证实，而且据报道，推迟积极治疗的患者生存率良好。根治性前列腺切除术或放射治疗前列腺癌的并发症包括死亡、阳痿、尿道狭窄、尿失禁和直肠损伤。目前，没有足够的证据支持PSA筛查政策，在随机对照试验证明PSA筛查有益之前，应不鼓励使用该方法。
