The U.S. Preventive Services Task Force (USPSTF) seeks comments on a draft recommendation statement and draft evidence reviews on screening for prostate cancer. Based on a review of the evidence, the USPSTF determined that the potential benefits and harms of prostate-specific antigen (PSA)–based screening are closely balanced in men ages 55 to 69 years. Screening offers a small potential benefit of reducing the chance of dying of prostate cancer. Research suggests that for every 1,000 men ages 55 to 69 offered prostate cancer screening with the PSA test, 240 would have a positive result, lead to positive biopsies in 100, and 80 of the 100 men would opt for definitive surgery or radiotherapy (65 immediately and 15 after a period of active surveillance); 1 to 2 men may avoid dying of prostate cancer, 3 men may avoid metastatic cancer over 10 to 15 years. However, The PSA test and followup prostate biopsies can’t tell for sure which cancers will likely be aggressive and spread, and research suggests that 20% to 50% of men diagnosed with prostate cancer after screening may be over diagnosed (that is, diagnosed with cancer that won’t affect their health during their lifetime). This means some men will benefit from treating screen-detected prostate cancer, but many more will be treated without benefit. Many men will experience potential harms of screening, including false-positive results that require additional workup, over diagnosis and over treatment, and treatment complications such as incontinence and impotence. More than 2 out of 3 men treated for prostate cancer with surgery to remove the prostate gland develop long-term sexual impotence and more than half of men treated with radiation develop long-term sexual impotence. The decision about whether to be screened should be an individual one. For men age 70 years and older, the potential benefits do not outweigh the harms, and these men should not be screened for prostate cancer. Source: https://screeningforprostatecancer.org/
美国预防医学工作组对前列腺癌筛查建议声明和证据审查草案征求意见。根据对证据的审查，美国预防医学工作组确定，在55至69岁的男性中，前列腺特异性抗原筛查的潜在益处和危害相当。筛查提供了点减少死于前列腺癌机会的潜在益处。研究表明，对年龄在55至69岁，通过前列腺特异性抗原检测进行前列腺癌筛查的每1000名男性，240例会是阳性，导致100例活检阳性，该100例中有80例会选择根治性手术或放射治疗（65例立即治疗，15例经过一段时间的主动观察）; 10至15年间1至2例可能会避免死于前列腺癌，3例可能会避免癌转移。然而，前列腺特异性抗原检测和随后的前列腺活检无法确定哪些癌症可能是恶性和转移性的，研究表明，筛查诊断的前列腺癌中有20％至50％可能是过度诊断（即诊断为癌症而在一生中不影响健康）。这意味着一些男性将受益于治疗筛查出的前列腺癌，但更多的是无益的治疗。许多男性将会受到筛查的潜在危害，包括需要进一步处理的假阳性，过度诊断和过度治疗，以及治疗所致并发症如失禁和阳萎。前列腺切除术治疗前列腺癌的男性中，超过3分之2的男性罹患长期阳萎，超过半数接受放射性治疗的男性罹患长期阳萎。是否被筛查的决定应该个体化。对于年龄在70岁以上的男性来说，潜在的益处并不大于危害，对这些男性不应给予前列腺癌筛查。来源：https://screeningforprostatecancer.org/