Prostate-specificy-antigen testing for early diagnosis of prostate cancer.
Prostate-specificy-antigen testing for early diagnosis of prostate cancer.
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DOI：
10.1056/nejm200105033441806
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发表时间：
2001-05-03
影响因子：
158.5
通讯作者：
Barry, MJ
中科院分区：
文献类型：
--
作者：
Barry, MJ
前言这篇日志以一个突出临床常见问题的病例小插曲开始。然后提出支持各种战略的证据，然后审查现有的正式准则。文章最后提出了作者的临床建议。阶段一个65岁的男性，除了年龄外没有前列腺癌的危险因素，直肠指检正常。前列腺特异性抗原（PSA）检测是否应该进行？临床问题1987年PSA检测的引入导致美国前列腺癌报告发病率的大幅增加。在1992年达到高峰后，发病率下降，大概是因为在接受检测的男子中发现了先前存在的病例。前列腺癌的死亡率在同一时期有升有降，原因尚不清楚（图1）。
ForewordThisJournalfeature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the author's clinical recommendations.StageA 65-year-old man with no risk factors for prostate cancer except his age has a normal digital rectal examination. Should a prostate-specific–antigen (PSA) test be ordered?The Clinical ProblemThe introduction of PSA testing in 1987 resulted in an enormous increase in the reported incidence of prostate cancer in the United States. After peaking in 1992, the incidence fell, presumably owing to the identification of preexisting cases among men who had been tested. The rate of death from prostate cancer has risen and fallen over the same period for reasons that are unclear (Figure 1).1Advocates of screening attribute . . .