Screening for prostate cancer
Screening for prostate cancer
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DOI：
10.1016/s0140-6736(03)12890-5
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发表时间：
2003-03-29
期刊：
影响因子：
168.9
通讯作者：
Neal, D
中科院分区：
文献类型：
--
作者：
Frankel, S;Smith, GD;Neal, D
从流行病学的角度来看，筛查是合理的，因为疾病的重要性和初级预防的前景缺乏，但自然史的证据没有帮助，因为男性更有可能死于前列腺癌，而不是死于前列腺癌。现有的筛查试验并不总能检测出病变可能导致未来发病或死亡的男性。通过筛查发现的局部癌症的治疗益处的证据有限，而危害的证据是明确的。人群筛查方案效果的观察性证据好坏参半，筛查强度与降低前列腺癌死亡率之间没有明确的关联。在低风险人群中进行前列腺癌筛查是不合理的，但在风险分层后，利与弊的平衡将更加有利。前列腺癌筛查只有在评估其有效性并帮助确定可能受益的群体的研究项目中才能被证明是合理的。
Epidemiologically, screening is,justified by the importance of the disease and the lack of prospects for primary prevention, but evidence from natural history is unhelpful since men are more likely to die with, rather than from, prostate cancer. The available screening tests do not always detect men whose lesions could result in future morbidity or mortality. Evidence is limited for the benefits of treatment for localised cancers detected through screening, whereas the evidence for harm is clear. Observational evidence for the effect of population screening programmes is mixed, with no clear association between intensity of screening and reduced prostate cancer mortality. Screening for prostate cancer cannot be justified in low-risk populations, but the balance of benefit and harm will be more favourable after risk stratification. Prostate cancer screening can be justified only in research programmes designed to assess its effectiveness and help identify the groups who may benefit.