Lefevre M L
University of Missouri School of Medicine, Columbia, USA.
Am Fam Physician. 1998 Aug;58(2):432-8.
The American Cancer Society and other national medical organizations emphasize the need for routine screening for prostate cancer in men over the age of 50. The serum prostate-specific antigen (PSA) assay is the test most commonly recommended for the purpose of screening. However, when PSA screening is examined critically from the standpoint of the principles of screening, evidence from prospective studies to support the routine use of PSA testing is lacking. Data suggest that screening often detects what may be indolent, nonaggressive prostate cancer. The treatment of such a cancer with radiation or radical prostatectomy can result in significant morbidity, including urinary incontinence and impotence, without a proven decrease in mortality. Evidence from randomized clinical trials in support of routine PSA screening is urgently needed.
美国癌症协会和其他国家医学组织强调，50岁以上男性有必要进行前列腺癌的常规筛查。血清前列腺特异性抗原（PSA）检测是最常用于筛查目的的测试。然而，从筛查原则的角度严格审视PSA筛查时，缺乏前瞻性研究的证据来支持常规使用PSA检测。数据表明，筛查常常会检测出可能是惰性、非侵袭性的前列腺癌。用放疗或根治性前列腺切除术治疗这类癌症可能会导致严重的并发症，包括尿失禁和阳痿，而且并未证实死亡率会降低。迫切需要来自随机临床试验的证据来支持常规PSA筛查。
