Profiling prostate cancer

摘要

Among men worldwide, prostate cancer has become the second most frequently diagnosed cancer and the sixth leading cause of cancer death, accounting for 240,890 new diagnoses and 33,720 deaths in the United States alone in 2011 (1, 2). Fortunately, with wide use of prostate cancer screening, early detection, and definitive local therapy, prostate cancer mortality rates have been falling in the United States-as much as 39% or more since 1990 (2). Nonetheless, randomized clinical trials of serum prostate-specific antigen (PSA) testing for prostate cancer screening have suggested that these gains have come at a significant cost: by one estimate, to save a single life from prostate cancer death, 1,410 men need to be screened, and 48 cases of prostate cancer need to be diagnosed and treated (3). On October 11, 2011, the US Preventive Services Task Force issued a draft report on PSA screening, assigning the practice a grade D recommendation and weighing in "against the service" because of "moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits."