Using the 4Kscore Test and Magnetic Resonance Imaging Results to Avoid Unnecessary Prostate Biopsy

[摘要] The death rate from prostate cancer in the United States has decreased by more than 40% since the 1990s, largely due to prostate-specific antigen (PSA) screening. The bottom line is that PSA screening has saved the lives of tens of thousands of American men. Therefore, recommendations to abandon PSA screening seem absurd, especially for health care professionals who have watched men die of prostate cancer. Those of us who endorse PSA screening agree that the lack of PSA specificity for significant prostate cancer resulted in hundreds of thousands of men undergoing unnecessary biopsy and tens of thousands undergoing radical prostatectomy or radiation therapy without benefit. Therefore, it is equally absurd to indiscriminately perform biopsies on men with an elevated PSA and offer aggressive treatment for all screen-detected cancers. So what is the solution? We must screen smarter and biopsy smarter, which will allow us to treat smarter! There is emerging evidence that we have the ability to both screen and biopsy smarter.

[学科分类] 基础医学