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前列腺癌查:美国预防服务工作组建议声明

, David C Grossman1, Susan J Curry2

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概括

使用前列腺特异性抗原 (PSA) 测试进行前列腺癌查对55-69岁的男性来说是少量的好处,需要个人做出决定. 不建议对70岁及以上的男性进行查,因为危害大于危害.

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科学领域:

  • 泌尿外科
  • 预防医学
  • 癌症学

背景情况:

  • 美国13%的男性患前列腺癌,
  • 许多前列腺癌无症状,通过查检测.
  • 非洲裔美国人和有家族病史的人面临更高的风险.

研究的目的:

  • 更新2012年美国预防服务工作组 (USPSTF) 关于基于PSA的前列腺癌查的建议.
  • 评估PSA查和随后治疗的益处和危害.
  • 分析高危人群中的查.

主要方法:

  • 美国PSTF审查了PSA查益处和危害的证据.
  • 审查决策分析模型和过度诊断率.
  • 在老年男性,非裔美国人和有家族病史的人群中进行了查.

主要成果:

  • 在55-69岁的男性中,PSA查可预防13年内每1000名男性中1. 3例死亡.
  • 查可以防止每1000名男性中发生3例转移.
  • 危害包括错误的阳性,过度诊断,勃起功能障碍和失禁;随着年龄的增长,危害增加.

结论:

  • 对于55-69岁的男性来说,PSA查的决定是个人的,平衡小益与危害,如失禁和勃起功能障碍.
  • 临床医生不应该选男性没有表达偏好.
  • 由于危害大于益处,不建议对70岁以上的男性进行PSA查.