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Screening for Prostate Cancer: The Debate Continues

机译:前列腺癌筛查:争论仍在继续

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摘要

Other than skin cancer, prostate cancer is the most frequently diagnosed cancer in men, and it is the second leading cause of cancer-related death for males in the United States. Screening for prostate cancer using prostate-specific antigen testing became widely used by the late 1980s, augmenting the digital rectal exam. This led to a decline in the percentage of prostate cancer cases that were metastatic at diagnosis and a decrease in prostate cancer mortality. But some argued it led to overtreatment of prostate cancers as well. Recently, the U.S. Preventive Services Task Force (USPSTF) issued recommendations against routine prostate cancer screening in asymptomatic patients. The recent recommendations have created much controversy among medical professionals, patient advocate groups, and the general public. Most prostate cancer screening recommendations from professional organizations agree that an informed discussion and review of each individual patient’s clinical situation should drive the decision to screen or not to screen, but the current USPSTF recommendations largely remove patient and provider autonomy in this regard. They do not contribute toward personalized screening based on individualized patient risk profiles, characteristics, and preferences.
机译:除皮肤癌以外,前列腺癌是男性中最常被诊断出的癌症,并且是美国男性与癌症相关的死亡的第二大主要原因。使用前列腺特异性抗原测试筛查前列腺癌已在1980年代后期广泛使用,从而扩大了直肠指检的范围。这导致在诊断时转移的前列腺癌病例的百分比下降以及前列腺癌死亡率的降低。但是有人认为这也导致了前列腺癌的过度治疗。最近,美国预防服务工作队(USPSTF)提出了对无症状患者常规前列腺癌筛查的建议。最近的建议在医学专业人士,患者倡导者团体和公众之间引起了很大争议。专业组织的大多数前列腺癌筛查建议都同意,对每位患者的临床情况进行知情的讨论和审查,应该可以决定是否进行筛查,但是目前的USPSTF建议在很大程度上消除了患者和医务人员的自主权。它们不会根据个性化的患者风险状况,特征和偏好进行个性化筛查。

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