Current Challenges in Prostate Cancer Management and the Rationale behind Targeted Focal Therapy.
Current Challenges in Prostate Cancer Management and the Rationale behind Targeted Focal Therapy.
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DOI：
10.1155/2012/862639
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发表时间：
2012
影响因子：
1.4
通讯作者：
Eid K
中科院分区：
文献类型：
--
作者：
Barqawi AB;Krughoff KJ;Eid K
在男性中，前列腺癌的患病率很高，与肺癌和结肠癌相比，癌症特异性死亡风险相对较低。前列腺特异性抗原（PSA）筛查自25年前作为筛查工具实施以来，提高了人们对前列腺癌的认识，但是，由于这种疾病的大部分惰性过程和PSA测试的非特异性，发病率增加在很大程度上与不会导致死亡的癌症有关（临床上无意义），导致过度诊断挑战和随之而来的过度治疗后果。过度治疗问题因目前治疗技术的高风险副作用而加剧，使患者的生活质量处于危险之中，几乎没有或没有生存益处。本文的目的是评估过度诊断和随之而来的过度治疗问题的上升，流行和影响，以及突出潜在的解决方案。在这项工作中，回顾了主要的流行病学和筛查研究，从前列腺特异性抗原筛查的出现到现在的癌症统计数据，以及患者关注和治疗结果的报告，以提出前列腺癌治疗当前挑战的主导因素，并阐明潜在的解决方案。
Among men, prostate cancer has a high prevalence, with relatively lower cancer-specific mortality risk compared to lung and colon cancer. Prostate-specific antigen (PSA) screening has increased prostate cancer awareness since its implementation as a screening tool almost 25 years ago, but, due to the largely indolent course of this disease and the unspecific nature of the PSA test, increased incidence has largely been associated with cancers that would not go on to cause death (clinically insignificant), leading to an overdiagnosis challenge and an ensuing overtreatment consequences. The overtreatment problem is exacerbated by the high risk of side effects that current treatment techniques have, putting patients' quality of life at risk with little or no survival benefit. The goals of this paper are to evaluate the rise, prevalence, and impact of the overdiagnosis and ensuing overtreatment problems, as well as highlight potential solutions. In this effort, a review of major epidemiological and screening studies, cancer statistics from the advent of prostate-specific antigen screening to the present, and reports on patient concerns and treatment outcomes was conducted to present the dominant factors that underlie current challenges in prostate cancer treatment and illuminate potential solutions.