Prostate cancer screening decreases the absolute risk of being diagnosed with advanced prostate cancer - Results from a prospective, population-based randomized controlled trial
Prostate cancer screening decreases the absolute risk of being diagnosed with advanced prostate cancer - Results from a prospective, population-based randomized controlled trial
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DOI：
10.1016/j.eururo.2006.07.012
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发表时间：
2007-03-01
期刊：
影响因子：
23.4
通讯作者：
Hugosson, Jonas
中科院分区：
文献类型：
--
作者：
Aus, Gunnar;Bergdahl, Suante;Hugosson, Jonas
目的：目前正在进行随机对照试验，以评估通过使用血清中的前列腺特异性抗原（PSA）测量进行早期检测是否会降低前列腺癌的死亡率。为了有效，这样的计划应该能够减少被诊断患有转移性前列腺癌（无法治愈）的男性的绝对数量。本报告的目的是评估是否PSA为基础的筛选降低风险被诊断为转移性prostate cancer.Methods：人群为基础的，前瞻性的，随机的，对照筛选试验前列腺癌开始于1995年（哥德堡分支的欧洲随机研究筛选前列腺癌[ERSPC]）。随机选择10,000名年龄在50-66岁之间的男性进行两年一次的PSA检测，其中10,000名男性作为被动对照，通过瑞典癌症登记处监测其转移性前列腺癌的诊断。经过10年的随访，被诊断为转移性前列腺癌的风险降低了48.9%，也就是说，从对照组的47例减少到随机分配到基于PSA的筛选组的24例（p = 0.0084）。然而，被诊断为前列腺癌的风险增加了1.8倍，PSA为基础的screening.Conclusions：两年一次的PSA筛查降低了被诊断为转移性前列腺癌的风险，这是年轻男性癌症死亡率降低的首要先决条件。这种假定的益处被前列腺癌诊断风险增加1.8倍所平衡。(c)2006年欧洲泌尿外科协会。Elsevier B. V.出版，保留所有权利。
Objectives: Randomized controlled trials are currently conducted to assess whether the mortality from prostate cancer is reduced by early detection with the use of prostate-specific antigen (PSA) measurements in serum. To be effective, such a program should be able to reduce the absolute number of men diagnosed with metastatic prostate cancer (for which no cure is available). The aim of the present report is to evaluate whether PSA-based screening reduces the risk of being diagnosed with metastatic prostate cancer.Methods: A population-based, prospective, randomized, controlled screening trial for prostate cancer started in 1995 (the Goteborg branch of the European Randomized Study of Screening for Prostate Cancer [ERSPC]). Ten thousand, randomly selected men aged 50-66 yr were invited for biennial PSA testing, with 10,000 men serving as passive controls for whom diagnosis of metastatic prostate cancer was monitored by using the Swedish Cancer Registry.Results: After a follow-up of 10 yr, the risk of being diagnosed with metastatic prostate cancer was reduced by 48.9%-that is, decreasing from 47 cases in the control group to 24 cases in the group randomized to PSA-based screening (p = 0.0084). However, the risk of being diagnosed with prostate cancer increased 1.8-fold with PSA-based screening.Conclusions: Biennial PSA screening reduces the risk of being diagnosed with metastatic prostate cancer, the first prerequisite for achieving decreased cancer mortality in younger men. This putative benefit is balanced by a 1.8-fold increased risk for diagnosis of prostate cancer. (c) 2006 European Association of Urology. Published by Elsevier B.V. All rights reserved.