Naito S, Kotoh S, Kumazawa J, Omoto T, Itoh K, Hatachi K, Shimizu Y, Yokoyama J, Nagayoshi H, Sagiyama K
Department of Urology, Faculty of Medicine, Kyushu University.
Nihon Hinyokika Gakkai Zasshi. 1993 Jul;84(7):1227-35. doi: 10.5980/jpnjurol1989.84.1227.
We analyzed the current status and problems of a screening for prostatic cancer (PCa) through a health examination in 12 hospitals in Fukuoka prefecture. From 1987 to 1991, a total of 16,126 subjects received this. The number of subjects who received this increased every year. In 5 hospitals in which such a screening is optional, however, only about 20% of subjects through a health examination received it each year. Furthermore, most of the subjects were in their 50s or 40s. Those in their 70s or more who are at higher risk for PCa rarely received such screening. PCa was detected in 6 subjects (0.04%) (well differentiated adenocarcinoma: 3, moderate differentiated adenocarcinoma: 3) in 5 years. Five were in stage B and treated with radical prostatectomy and one was in stage C and hormonal therapy was performed. The mean age of the 6 patients was 57.7 year old ranging from 51 to 66. The incidence of PCa detected by a screening in dock increased with age. Prostate specific antigen (PSA) was considered to be more useful for detecting prostate cancer in dock as compared with digital examination (DRE), transrectal ultrasonography or prostatic acid phosphatase because of its relatively high sensitivity (83.3%) and specificity (84.8%). The incidence of PCa detected with combination of DRE and determination of PSA was 0.15% and significantly higher than that detected with DRE alone, 0.01%. These results suggest the need for enlightenment on PCa and the significance of a screening with combination of DRE and determination of PSA through a health examination for detecting early stage of PCa.
我们分析了福冈县12家医院通过健康检查进行前列腺癌（PCa）筛查的现状及问题。1987年至1991年，共有16126名受试者接受了此项检查。接受检查的受试者人数逐年增加。然而，在5家可选择进行此类筛查的医院中，每年通过健康检查接受筛查的受试者仅约20%。此外，大多数受试者年龄在四五十岁。而70岁及以上患PCa风险较高的人群很少接受此类筛查。5年内共检测出6例PCa患者（0.04%）（高分化腺癌：3例，中分化腺癌：3例）。5例为B期，接受了根治性前列腺切除术，1例为C期，进行了激素治疗。6例患者的平均年龄为57.7岁，年龄范围在51岁至66岁之间。船坞筛查检测出的PCa发病率随年龄增长而增加。与直肠指检（DRE）、经直肠超声检查或前列腺酸性磷酸酶相比，前列腺特异性抗原（PSA）因其相对较高的敏感性（83.3%）和特异性（84.8%），被认为在船坞检测前列腺癌时更有用。DRE联合PSA检测的PCa发病率为0.15%，显著高于单独使用DRE检测的发病率（0.01%）。这些结果表明，有必要加强对PCa的宣传，以及通过健康检查联合DRE和PSA检测对早期PCa进行筛查的重要性。
