在初级保健中进行PSA检测:是时候改变我们的做法了吗?
Frederique Beatrice Denijs1, Hendrik Van Poppel2,3, Arnulf Stenzl4,5
1Department of Urology, Erasmus Cancer Institute, Erasmus University Medical Centre, Rotterdam, The Netherlands.
BMC primary care
|December 26, 2024
概括
针对前列腺癌的机会性前列腺特异性抗原 (PSA) 测试在初级保健医生中显示出不同的模式. 需要一个结构化,风险适应的方法来改善早期检测,同时尽量减少过度诊断和过度治疗.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 主要护理医学 医疗保健
- 公共卫生 公共卫生
背景情况:
- 过去的前列腺特异性抗原 (PSA) 查减少了前列腺癌死亡率,但导致过度诊断/过度治疗.
- 目前的机会性PSA测试趋势显示晚期诊断和前列腺癌死亡人数的增加.
研究的目的:
- 审查目前的PSA检测趋势在初级保健.
- 提出一个合作战略,以提高前列腺癌的早期检测.
主要方法:
- 审查PSA测试当前的趋势.
- 分析全科医生 (GPs) 和家庭医生 (FDs) 的测试模式.
- 关于风险调整的查战略的建议.
主要成果:
- 由于不同的指导方针,患者因素和医生偏好,PSA测试模式在全科医生/前期医生之间存在显著差异.
- 一个有组织的,适应风险的策略可以改善早期诊断的前列腺癌.
- 建议国家查计划和改善GP/FD支持.
结论:
- 一般医生/FD在为男性提供关于PSA测试资格的咨询方面至关重要.
- 在这个角色中,更明确的指导,培训和支持对一般医生/FD至关重要.
- 适应风险的策略和患者信息可以减轻过度诊断和心理社会后果.
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