Prostate cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up.

摘要

The crude annual incidence of prostate cancer in the European Union is 78.9/100 000 men. It is the most common cancer in men. The mortality in the EU is 30.6/100 000 men/year [II, C]. Though the incidence and survival rates vary widely between different EU States, mortality rates are similar [II, C]. Subclinical prostate cancer is common in men >50 years [II, A]. Population-based screening of healthy men between 55 and 69 years old reduces prostate cancer mortality by an estimated 20 % using prostate-specific antigen (PSA) testing. Screening increases the prostate cancer incidence and leads to diagnosis of asymptomatic cancers that will not emerge during life. The European screening trial suggests an absolute reduction in prostate cancer mortality of 0.71 deaths per 1000 men after a median follow-up of 9 years, but at the cost of 48 additional radical treatments per life saved. There was no reduction in overall mortality. Decisions on population screening await longer follow-up and the results of analyses of cost-effectiveness and quality of life [I, B].