Abstract:
Prostate cancer, the most common cause of cancer in men in the UK and one of the most common around the world to date, has no consensus on screening. Multiple large-scale trials from around the world have produced conflicting outcomes in cancer-specific and overall mortality. A main part of the issue is the PSA test, which has a high degree of variability, making it challenging to set PSA thresholds, as well as limited specificity. Prostate cancer has a predisposition in men from black backgrounds, and outcomes are worse in men of lower socioeconomic groups. Mobile targeted case finding, focusing on high-risk groups, may be a solution to help those that most need it. The aim of this systematic review was to review the evidence for mobile testing for prostate cancer. A review of all mobile screening studies for prostate cancer was performed in accordance with the Cochrane guidelines and the PRISMA statement. Of the 629 unique studies screened, 6 were found to be eligible for the review. The studies dated from 1973 to 2017 and came from four different continents, with around 30,275 men being screened for prostate cancer. Detection rates varied from 0.6% in the earliest study to 8.2% in the latest study. The challenge of early diagnosis of potentially lethal prostate cancer remains an issue for developed and low- and middle-income countries alike. Although further studies are needed, mobile screening of a targeted population with streamlined investigation and referral pathways combined with raising awareness in those communities may help make the case for screening for prostate cancer.
摘要:
前列腺癌,英国男性最常见的癌症原因,也是迄今为止世界上最常见的癌症之一,对筛查没有共识。来自世界各地的多项大规模试验在癌症特异性和总死亡率方面产生了相互矛盾的结果。问题的主要部分是PSA测试,具有高度的可变性,设定PSA阈值具有挑战性,以及有限的特异性。前列腺癌有黑人背景的男性倾向,社会经济地位较低的男性的结果更差。移动目标案件调查,重点关注高危人群,可能是一个解决方案,以帮助那些最需要它。本系统综述的目的是回顾前列腺癌移动检测的证据。根据Cochrane指南和PRISMA声明,对所有前列腺癌的移动筛查研究进行了回顾。在筛选的629项独特研究中,发现6人符合审查条件。这些研究始于1973年至2017年,来自四个不同的大陆,大约有30,275名男性接受前列腺癌筛查。检出率从最早研究的0.6%到最新研究的8.2%不等。对于发达国家和低收入和中等收入国家来说,早期诊断潜在致命性前列腺癌的挑战仍然是一个问题。虽然还需要进一步的研究,通过简化调查和转诊途径对目标人群进行流动筛查,并提高这些社区的意识,可能有助于为前列腺癌筛查提供依据.