前列腺癌查:证据,正在进行的试验,政策和知识差距
Ola Bratt1,2, Anssi Auvinen3, Rebecka Arnsrud Godtman1,2
1Department of Urology, Institute of Clinical Sciences, University of Gothenburg, Sahlgrenska Academy, Goteborg, Sweden.
BMJ oncology
|January 31, 2025
概括
使用前列腺特异抗原 (PSA) 和活检可以改善前列腺癌查. 新的方法减少了低级癌症的过度诊断,使致命的前列腺癌能够更有选择性地检测.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 在瘤学瘤学.
- 预防医学 预防医学
背景情况:
- 用PSA和活检进行前列腺癌查可以降低死亡率,但会导致过度诊断.
- 诊断和了解低度前列腺癌的进展使得更有选择性的检测成为可能.
研究的目的:
- 审查诊断方面的进展,查试验,政策和前列腺癌检测方面的知识差距.
- 为减少过度诊断的策略提供信息,同时保持死亡率的好处.
主要方法:
- 对诊断方法,查试验和医疗保健政策的非系统性审查.
- 对血清PSA,风险计算器,生物标志物和前列腺癌诊断MRI的证据综合.
主要成果:
- 低血清PSA水平允许调整查间隔.
- 风险计算器,生物标志物和MRI引导的活检减少了低级癌症的检测和过度诊断.
- 欧盟建议评估有组织的前列腺癌查计划.
结论:
- 现代诊断工具可以显著减少前列腺癌查中的过度诊断.
- 目前正在进行的试验和试点计划对于解决关于长期有效性和死亡率影响的剩余知识差距至关重要.
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