Hansen M V, Grönberg A
Department of Urology, Halmstad Hospital, Sweden.
Eur Urol. 1995;28(3):196-201. doi: 10.1159/000475051.
The attitudes of 656 European urologists toward therapy of localized prostatic cancer (PC) and screening examinations of the male population for PC were surveyed. Eighty percent of the urologists would offer curative therapy to a 60-year-old patient with localized PC, while 20% would offer watchful waiting or hormonal therapy. The choice of curative therapy was not correlated to the grade of the cancer. Radical prostatectomies were offered 2.5 times as often as external beam radiotherapy. The number of radical prostatectomies performed was considered to be increasing by 56% of the urologists surveyed, decreasing by 10% and stable by 34%. Fifty-five percent thought that screening for prostate cancer should be undertaken in their country, but only 35% believed this would decrease mortality from prostate cancer. A majority would include digital rectal examination, prostate-specific antigen and symptom evaluation in a screening program. Agreement among urologists from different European countries regarding the handling of early prostatic cancer is poor. Large regional differences were observed with a more active attitude to therapy and screening in southern and central Europe. Attitudes to screening and to therapy, however, were only weakly correlated. In conclusion, it seems paradoxal that many urologists who would offer curative therapies to patients with localized PC would not take steps to diagnose this disease via screening of the male population.
对656名欧洲泌尿外科医生关于局限性前列腺癌（PC）治疗以及男性人群PC筛查检查的态度进行了调查。80%的泌尿外科医生会为一名60岁局限性PC患者提供根治性治疗，而20%会选择观察等待或激素治疗。根治性治疗的选择与癌症分级无关。提供根治性前列腺切除术的频率是体外放疗的2.5倍。参与调查的泌尿外科医生中，56%认为根治性前列腺切除术的实施数量在增加，10%认为在减少，34%认为保持稳定。55%认为他们所在国家应该开展前列腺癌筛查，但只有35%相信这会降低前列腺癌死亡率。大多数人会将直肠指检、前列腺特异性抗原和症状评估纳入筛查项目。不同欧洲国家的泌尿外科医生在早期前列腺癌处理上的共识较差。在欧洲南部和中部，对治疗和筛查的态度更为积极，存在较大的地区差异。然而，对筛查和治疗的态度之间仅有微弱的相关性。总之，看似矛盾的是，许多会为局限性PC患者提供根治性治疗的泌尿外科医生却不会通过对男性人群进行筛查来诊断这种疾病。
