Screening for Prostate Cancer With Prostate-Specific Antigen Testing: American Society of Clinical Oncology Provisional Clinical Opinion
Screening for Prostate Cancer With Prostate-Specific Antigen Testing: American Society of Clinical Oncology Provisional Clinical Opinion
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DOI：
10.1200/jco.2012.43.3441
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发表时间：
2012-08-20
影响因子：
45.3
通讯作者：
Nam, Robert K.
中科院分区：
文献类型：
--
作者：
Basch, Ethan;Oliver, Thomas K.;Nam, Robert K.
美国临床肿瘤学会（ASCO）临时临床意见（PCO）在发表或介绍来自主要研究的潜在实践改变数据后，为ASCO会员提供及时的临床指导。前列腺特异性抗原（PSA）是前列腺癌的一个重要标志，是前列腺癌的一个重要标志，也是前列腺癌的一个重要标志。筛查男性前列腺癌的基本原理是通过早期检测降低死亡风险的潜力。来自2011年医疗保健研究和质量机构系统综述的最新数据证据主要告知本PCO基于PSA的筛查的益处和危害。更新搜索进行到2012年3月16日，为更多的证据相关的topic.ResultsIn一项随机试验，PSA测试的男性谁不会，否则已经筛选导致前列腺癌的死亡率降低，但它是不确定的效果的大小是否值得与筛查和随后的不必要的治疗相关的危害。尽管现有数据存在局限性，但有证据表明，预期寿命较长的男性可能会从PSA检测中受益。对于大多数男性而言，与前列腺活检相关的不良事件较低;然而，几项基于人群的研究显示前列腺活检后感染并发症的发生率增加，这是一个值得关注的问题。
PurposeAn American Society of Clinical Oncology (ASCO) provisional clinical opinion (PCO) offers timely clinical direction to the ASCO membership after publication or presentation of potentially practice-changing data from major studies. This PCO addresses the role of prostate-specific antigen (PSA) testing in the screening of men for prostate cancer.Clinical ContextProstate cancer is the second leading cause of cancer deaths among men in the United States. The rationale for screening men for prostate cancer is the potential to reduce the risk of death through early detection. Recent Data Evidence from a 2011 Agency for Healthcare Research and Quality systematic review primarily informs this PCO on the benefits and harms of PSA-based screening. An update search was conducted to March 16, 2012, for additional evidence related to the topic.ResultsIn one randomized trial, PSA testing in men who would not otherwise have been screened resulted in reduced death rates from prostate cancer, but it is uncertain whether the size of the effect was worth the harms associated with screening and subsequent unnecessary treatment. Although there are limitations to the existing data, there is evidence to suggest that men with longer life expectancy may benefit from PSA testing. Adverse events associated with prostate biopsy are low for the majority of men; however, several population-based studies have shown increasing rates of infectious complications after prostate biopsy, which is a concern.