Uchida K, Akaza H
Dept. of Urology, University of Tsukuba, Japan.
Gan To Kagaku Ryoho. 1998 Aug;25(10):1527-32.
Prostate cancer has the highest incidence and the second most common cause of death in U.S. men. In Japanese men, prostate cancer is not so common but is the most increasing neoplasm. Detection of early-stage cancer and early curative treatment are the most effective ways to reduce mortality from this disease. Therefore the mass screening system for prostate cancer to reduce mortality has become an important issue in recent years in Japan. The screening project for prostate cancer was conducted using only the prostate specific antigen (PSA) levels of primary screening with the cut off level of 4.0 ng/ml for candidates undergoing a medical checkup every 2 years. Totally, 20,338 men had health checkups every 2 years and 899 men requested the screening checkup for prostate cancer and their serum PSA level. Fifty (5.6%) men showed abnormal PSA level, 41 men had a second screening, 27 men underwent needle biopsy of prostate, and finally 14 cases of prostate cancer were detected. The detection rate calculated for prostate cancer was 1.56%. Thirteen cases out of 14 (92.9%) were clinically diagnosed as localized cancer. In 10 cases, total prostatectomy was performed and the pathological findings showed none of them to be clinically insignificant cancers. In conclusion, from our result the screening of prostate cancer using PSA only is considered to be very useful to detect early clinically significant prostate cancer.
前列腺癌在美国男性中发病率最高，是第二大常见死因。在日本男性中，前列腺癌并不常见，但却是增长最快的肿瘤。早期癌症的检测和早期治疗是降低该疾病死亡率的最有效方法。因此，近年来在日本，用于降低死亡率的前列腺癌大规模筛查系统已成为一个重要问题。前列腺癌筛查项目仅使用初次筛查的前列腺特异性抗原（PSA）水平，每两年接受一次体检的候选人的临界值为4.0 ng/ml。总共有20338名男性每两年进行一次健康检查，899名男性要求进行前列腺癌筛查检查及其血清PSA水平检测。50名（5.6%）男性PSA水平异常，41名男性进行了二次筛查，27名男性接受了前列腺穿刺活检，最终检测出14例前列腺癌。前列腺癌的检出率为1.56%。14例中有13例（92.9%）临床诊断为局限性癌症。10例患者接受了前列腺全切术，病理结果显示均无临床意义不显著的癌症。总之，从我们的结果来看，仅使用PSA筛查前列腺癌被认为对早期临床显著前列腺癌的检测非常有用。
