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攝護腺癌篩檢未能利大於弊

攝護腺癌的發生率與死亡率
根據國民健康署民國101年癌症登記顯示,101年有4,735位罹患攝護腺癌,發生率為每十萬人口29.7人,為我國男性癌症發生率第五位,102年有1,207位死於攝護腺癌,死亡率為每十萬人口為6.6人,為我國男性癌症死因第七位。相較於其他歐美國家,我國攝護腺癌之發生率和死亡率都較歐美低,發生率為美國的1/8,死亡率為美國的1/2。

攝護腺癌的篩檢工具
早期的攝護腺癌幾乎沒有症狀,當症狀出現時往往已是晚期,其可能的症狀如血尿或精液中含血、頻尿(特別是夜間)、尿流微弱或中斷、排尿困難、排尿疼痛或灼熱、腰部/骨盆/大腿持續疼痛,但攝護腺感染或是攝護腺肥大等問題,也可能引起上述症狀 https://www.tmua.org.tw/ptEdu-activeSurveillance.htm...
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One in six men will be diagnosed with prostate cancer during their lifetime but screening may result in the overdiagnosis and overtreatment of prostate cancer. Prostate cancer screening - Wikipedia
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Risks of over treatment of prostate cancerOver diagnosis is the detection of a cancer that would otherwise not have been diagnosed in the lifetime of the host if the detection test ( PSA aor prostate biopsy) had not been performed. Treatment of men who would otherwise not have known about their cancer in the absence of PSA testing and biopsy are over treated
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The goal of surveillance is to avoid overtreatment and the sometimes serious, permanent side effects of treatment for a slow-growing or self-limited tumor (that in most people, would be unlikely to cause problems). This approach is not used for aggressive cancers, but it may cause anxiety for people
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who wrongly believe that all cancer is deadly or themselves to have life-threatening cancer. For 50% to 75% of people with prostate cancer it will cause no harm before a person dies from other causes.[113]
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冷凍治療可以減少排尿問題,但是勃起困難的可能則提高到90%。冷凍治療用來作攝護腺癌的起始治療,效果不如手術或是放射治療[22]。但用來治療放射治療後復發的癌症則比根治式攝護腺切除術好。
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