Prostate-specific antigen-based population screening for prostate cancer: current status in Japan and future perspective in Asia.
Prostate-specific antigen-based population screening for prostate cancer: current status in Japan and future perspective in Asia.
复制标题
前列腺特异性抗原对前列腺癌的种群筛查：日本的现状和亚洲的未来观点。
DOI：
10.4103/1008-682x.143756
复制
发表时间：
2015-05
影响因子：
2.9
通讯作者：
Namiki M
中科院分区：
文献类型：
--
作者：
Kitagawa Y;Namiki M
在西方国家，前列腺癌筛查的临床试验表明对患者生存的益处有限。在包括日本在内的亚太地区，前列腺特异性抗原（PSA）检测率与西方国家相比仍然很低，基于人群的筛查的益处尚不清楚。本文综述了日本前列腺癌人群筛查和诊断的现状，并讨论了人群筛查在亚洲人群中的效果。自20世纪90年代以来，日本的每个市政府都实施了筛查系统，预计在PSA筛查暴露率显著增加的一些地区，前列腺癌死亡率将有所下降。基于人群的筛查队列显示，随着暴露率的增加，筛查发现的癌症中转移性疾病的比例逐渐下降，人群筛查开始后血清PSA水平高的癌症比例呈下降趋势。通过人群筛查检测到的前列腺癌的预后比在人群筛查之外诊断出的前列腺癌更有利。最近在筛查队列中的结果证实了PSA的有效性。这些关于日本人群筛查的最新证据可能有助于在亚洲个体中建立最佳的前列腺癌筛查系统。
In Western countries, clinical trials on prostate cancer screening demonstrated a limited benefit for patient survival. In the Asia-Pacific region, including Japan, the rate of prostate-specific antigen (PSA) testing remains very low compared with Western countries, and the benefits of population-based screening remain unclear. This review describes the current status of population screening and diagnosis for prostate cancer in Japan and discusses the efficacy of population screening for the Asian population. Since the 1990s, screening systems have been administered by each municipal government in Japan, and decreases in the prostate cancer mortality rate are expected in some regions where the exposure rate to PSA screening has increased markedly. A population-based screening cohort revealed that the proportion of metastatic disease in cancer detected by screening gradually decreased according to the increased exposure rate, and a decreasing trend in the proportion of cancer with high serum PSA levels after population screening was started. The prognosis of the prostate cancer detected by population screening was demonstrated to be more favorable than those diagnosed outside of the population screening. Recent results in screening cohorts demonstrated the efficacy of PSA. These recent evidences regarding population-based screening in Japan may contribute to establishing the optimal prostate cancer screening system in Asian individuals.