Early recognition in urology

摘要

abstract_textpAccording to the guidelines on early cancer detection measures of the German Federal Joint Committee exploration of the medical history and physical examination of the penis and testes as well as digital rectal examination are recommended in men. The interdisciplinary S3 guidelines on prostate cancer recommend that for early detection of prostate cancer the combination of digital rectal examination and prostate-specific-antigen determination should always be offered for well-informed men. Data on prostate cancer screening suggest a significant reduction of tumor-specific mortality. The results of the ERSPC study revealed a number needed to screen (NNS) of 357 and a number needed to treat of 23 to prevent 1 man dying from metastatic prostate cancer. The Goteborg study with a median follow-up of 14 years even shows a NNS of 293 and 12 men needed to be diagnosed to prevent 1 prostate cancer death. Thus, PSA-based early detection reduces the rate of cancer-specific mortality by 31-56. In contrast insufficient data exist to allow a risk-benefit analysis of screening for kidney cancer, transitional cell carcinoma of the bladder or upper urinary tract as well as for testicular cancer./p/abstract_text