Screening for prostate cancer with prostate-specific antigen (PSA) testing has been widespread in the United States since the late 1980s. Remarkably, it was not until 2009 that good evidence was published on the effectiveness of PSA screening, when the results of the PLCO (Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial) and the ERSPC (European Randomized Study of Screening for Prostate Cancer) appeared together in the New England Journal of Medicine (1, 2). Their findings seemed contradictory: The PLCO found low rates of prostate cancer death that did not differ significantly between groups (1), whereas the ERSPC suggested that screening reduced prostate cancer mortality by 20% (2).

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前列腺癌筛查：质疑如何优化收益与危害比率的时间

自1980年代后期以来，在美国广泛采用前列腺特异性抗原（PSA）检测筛查前列腺癌。值得注意的是，直到2009年，当PLCO（前列腺癌，肺癌，结肠直肠癌和卵巢癌筛查试验）和ERSPC（欧洲前列腺癌筛查随机研究）的结果发布时，才有充分的证据证明PSA筛查的有效性。 ）一起出现在《新英格兰医学杂志》上（1，2）。他们的发现似乎是矛盾的：PLCO发现前列腺癌的低死亡率在两组之间没有显着差异（1），而ERSPC建议筛查将前列腺癌的死亡率降低20％（2）。