Shared decision making for prostate cancer screening: do patients or clinicians have a choice?

摘要

THE PROSTATE-SPECIFIC ANTIGEN (PSA) TEST was introduced in the late 1980s. Twenty years later there remains inadequate evidence about its benefits and harms when used for screening. The seriousness of the disease is unquestioned-prostate cancer claimed an estimated 28 660 lives in 2008-and the human toll impels the public, clinicians, and the public health community to act. However, evidence that early detection improves outcomes is scant, the often latent forms of the disease may pose little clinical threat to patients, false-positive results are common, and the harms and downstream consequences may outweigh the benefits.