PSA Screening in Prostate Cancer
نویسنده
چکیده مقاله:
Introduction: Prostate cancer is one of the most common cancers in Iranian men. PSA(prostate specific antigen) screening is a controversial issue because PSA screening leads to diagnose of patients with low risk prostate cancer who not only do not benefit from treatment but also suffer from complication caused by treatment. On the other hand, without prostate cancer screening, the rate of metastatic prostate cancer will increase. This article is a narrative review article on PSA screening, reviewing clinical trial articles in the PubMed. Methods: We searched PubMed using keywords: “PSA, Prostate Cancer and Screen” and English as well as full text articles were included. Only clinical trial studies were included. Case studies, cohort studies and review articles were excluded. 301 articles were found. Our emphasis was on four questions on benefits and harms of PSA screening and benefits and harms of prostate cancer treatment for localized prostate cancer were reviewed. Finally 15 articles were included. References from included studies were manually reviewed to identify additional studies of interest. Results: PLCO AND CAP studies showed that PSA screening does not lead to decreased prostate cancer mortality but ERSPC study showed 21% decrease in prostate cancer mortality among people who screen for prostate cancer. The most problem in prostate cancer screening is over diagnosis. These studies revealed over diagnosis in 20.7% to 50.4% of patients who were screened with PSA. Pivot and PROTECT studies revealed radical prostatectomy for patients with localized prostate cancer detected with PSA screening, does not significantly increase the survival of prostate cancer, however; SPCG-4 study showed that radical prostatectomy significantly increased survival of localized prostate cancer. Conclusion: Active surveillance of low-risk prostate cancer or supplemental tests such as PHI (prostate health index) and Multiparametric MRI in cases where PSA is slightly higher than normal is recommended for PSA screening.
منابع مشابه
PSA screening for prostate cancer.
Screening of prostate cancer with prostate-specific antigen (PSA) is a highly controversial issue. One part of the controversy is due to the confusion between population screening and early diagnosis, another derives from problems related to the quality of existing screening studies, the results of radical curative treatment for low grade tumors and the complications resulting from treatments t...
متن کاملPSA Screening for Prostate Cancer.
Narrative: U.S. men have a 16% chance of a prostate cancer diagnosis in their lifetime and a 3% chance of dying from prostate cancer.1 Autopsy studies have shown that up to two-thirds of older men die with asymptomatic prostate cancer. It appears that most men will develop prostate cancer if they live long enough, although it usually does not affect longevity.1 Given the high incidence of prost...
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question whether the recent decline in age-standardized prostate cancer mortality rates in Quebec could be attributed to screening with the serum prostate-specific antigen (PSA) test. By comparing the change in the incidence rate of prostate cancer between 1989 and 1993 with the change in the prostate cancer mortality rate between 1995 and 1999 in 15 birth cohorts, and in 15 regions of Quebec, ...
متن کاملPSA screening and prostate cancer mortality.
BACKGROUND Physicians have speculated that prostate-specific antigen (PSA) screening may be responsible for the reduction in prostate cancer mortality observed in the late 1 990s. In order to test this hypothesis, we assessed the relation between the change in prostate cancer incidence in the early 1990s, attributed largely to PSA screening, and the subsequent change in prostate cancer mortalit...
متن کاملMetastatic prostate cancer in the modern era of PSA screening
INTRODUCTION To characterize initial presentation and PSA screening status in a contemporary cohort of men treated for metastatic prostate cancer at our institution. MATERIALS AND METHODS We reviewed records of 160 men treated for metastatic prostate cancer between 2008-2014 and assessed initial presentation, categorizing patients into four groups. Groups 1 and 2 presented with localized dise...
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عنوان ژورنال
دوره 39 شماره None
صفحات 159- 163
تاریخ انتشار 2021-11
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