Discussion on Screening for Prostate Cancer_Chinese Journal of Evidence-Based Medicine

Authors：

XU Yang , DONG Birong

Department of Geratology; West China Hospital; Sichuan University; Chengdu 610041; China;

Corresponding author：

Keywords：

Prostate cancer; Screening; Prostate-specific antigen

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Abstract Full text Figures/Tables Video References Cited by

Prostate cancer is a common disease in the USA and Europe, with a gradually increasing incidence in China, and presents a significant health burden for older men. The lack of modifiable risk factors has made early detection as a strategy to reduce mortality. Current methods of screening involve the measurement of serum prostate-specific antigen (PSA) and digital rectal examination followed by biopsy. With PSA screening evidence of level I absent, the evidence on the use of PSA as a screening test is still highly controversial. Furthermore, there is controversy over whether screen-detected lesions will become clinically significant. There are three major treatment options for localized disease: radical prostatectomy, radical radiotherapy and monitoring with treatment if required. There is no evidence of randomized controlled trial (RCT) to suggest a survival advantage of any of these treatments. Opinions about the related benefits and risks of screening vary widely. In the absence of RCT of benefit for screening, many now suggest “informed consensus” screening, which encourages a discussion between the patient and his physician with both sides informed of all of the issues.

Citation： XU Yang,DONG Birong. Discussion on Screening for Prostate Cancer. Chinese Journal of Evidence-Based Medicine, 2004, 04(11): 801-805. doi: Copy

1.	［1］Hsing A, Tsao L, Devesa S. International trends and patterns of prostate cancer incidence and mortality[J]. Int J Cancer, 2000; 85(1): 60-67.
2.	［2］Liu YT, Li YX, Cheng W. The incidence change of urinary tumor[J]. Journal of Clinical Urology, 1997; 12(6): 4748.
3.	刘耀庭, 李秀霞, 程伟. 泌尿外科肿瘤发病情况的变化[J]. 临床泌尿外科杂志, 1997; 12(6): 47～48.
4.	［3］Gu FL. Epidemiological survey of benign prostatic hyperplasia and prostate cancer in China[J]. Journal of Beijing Medical University, 2000; 32(1): 3033.
5.	顾方六, 我国良性前列腺增生和前列腺癌发病调查[J]. 北京医科大学报, 2000; 32(1): 30～33.
6.	［4］Xu ZB, Wang GM, Sun LA, Zhang YK, The incidence of prostate carcinoma in Shanghai[J]. Clinical Medical Journal of China, 2003; 10(3): 344346.
7.	徐志兵, 王国民, 孙立安, 张永康. 上海市市区前列腺癌发病情况调查分析[J]. 中国临床医学, 2003; 10(3): 344～346.
8.	［5］Von Eschenbach A, Ho R, Murphy GP, Cunningham M, Lins N. American Cancer Society guideline for the early detection of prostate cancer: update 1997[J]. CA Cancer J Clin, 1997; 47(3): 261-264.
9.	［6］Brenda E. Sirovich; Lisa M. Schwartz; Steven Woloshin Screening men for prostate and colorectal cancer in the united states: does practice reflect the evidence?[J]. JAMA, 2003; 289(5): 1 414 -1 420.
10.	［7］Jacobsen SJ, Katusic SK, Berstralh EJ, Oesterling JE. Ohrt D. Klee GG. Chute CG. Lieber MM. Incidence of prostate cancer diagnosis in the eras before and after serum prostate-specific antigen testing[J]. JAMA, 1995; 271(6): 1 445.
11.	［8］Edwards B, Howe H, Ries L, Thun MJ, Rosenberg HM, Yancik R. Annual report to the nation on the status of cancer, 19731999, featuring implications of age and aging on U.S. cancer burden[J]. Cancer, 2002; 94(45): 2 766-2 792.
12.	［9］Brawer MK. Screening for prostate cancer[J]. Sem Surg Oncol 2000; 18(7): 29-36.
13.	［10］W. Sakr, N. Pernick, C. Butler, H. Nassar, V. Pansare, D. Grignon, The prevalence of high grade, clinically occult prostatic adenocarcinoma and its relationship to high grade PIN[M], Abstract 656, American Urological Association, July 2000.
14.	［11］Nam RK, Jewett MAS, Krahn MD. Prostate cancer: 2. Natural history[J].CMAJ,1998; 159(8): 685-691.
15.	［12］Sakr WA, Haas GP, Cassin BJ, Pontes JE, Crissman JD.The frequency of carcinoma and intraepithelial neoplasia of the prostate in young male patients[J]. J Urol, 1993; 150(65): 379-385.
16.	［13］Rosen MA. Impact of prostate-specific antigen screening on the natural history of prostate cancer[J]. Urology, 1995; 46(43): 757-768.
17.	［14］Mistry K. Cable G. Meta-analysis of prostate-specific antigen and digital rectal examination as screening tests for prostate carcinoma[J]. J Am Board Fam Pract. 2003; 16(2): 95-101.
18.	［15］Arjen Hoogendam, Frank Buntinxa, Henrica CW de Vetb. The diagnostic value of digital rectal examination in primary care screening for prostate cancer: a meta-analysis[J]. Family Practice,2003; 16(6): 621-626.
19.	［16］Flanigan RC, Catalona WJ, Richie JP, Ahmann FR, Hudson MA. Accuracy of digital rectal examination and transrectal ultrasonography in localizing prostate cancer[J]. J Urol, 1994; 152(34): 1 506-1 509.
20.	［17］Hammerer P, Huland H. Systematic sextant biopsies in 651 patients referred for prostate evaluation[J]. J Urol,1994; 151(33): 99-102.
21.	［18］Ellis WJ, Chetner MP, Preston SD, Brawer MK. Diagnosis of prostatic carcinoma: the yield of serum prostate specific antigen, digital rectal examination and transrectal ultrasonography[J]. J Urol,1994; 52(2): 1 500-1 525.
22.	［19］Catalona WJ, Smith DS, Ratliff TL, Basler JW. Detection of organ-confined prostate cancer is increased through prostate specific antigen based screening[J]. JAMA,1993; 270(56): 948-954.
23.	［20］Kamoi K, Babaian RJ. Advances in the application of prostate-specific antigen in the detection of early-stage prostate cancer[J]. Sem Oncol, 1999; 26(3): 140-149.
24.	［21］Catalona WJ, Partin AW, Slawin KM. Use of the percentage of free prostatic specific antigen to enhance differentiation of prostate cancer from benign prostatic disease: a prospective multicenter clinical trial[J]. JAMA, 1998; 279(34): 1 542-1 547.
25.	［22］Catalona WJ, Partin AW, Slawin KM. Use of the percentage of free prostatic specific antigen to enhance differentiation of prostate cancer from benign prostatic disease: a prospective multicenter clinical trial[J]. JAMA, 1998; 279(34): 1 542-1 547.
26.	［23］Woodrum DL, Brawer MK, Partin AW, Catalona WJ, Southwick PC. Interpretation of free prostate specific antigen clinical research studies for the detection of prostate cancer[J]. J Urol, 1998; 159(3): 5-12.
27.	［24］Smith DS, Catalona WJ, Herschman JD. Longitudinal screening for prostate cancer with prostate-specific antigen. JAMA, 1996; 276(25): 1 309-1 315.
28.	［25］Keetch DW, Catalona WJ, Smith DS. Serial prostatic biopsies in men with persistently elevated serum prostate specific antigen values[J]. J Urol, 1994; 151(56): 1 571-1 574.
29.	［26］Roehl KA. Antenor JA. Catalona WJ. Serial biopsy results in prostate cancer screening study[J]. J Urol, 2002; 167(6): 2 435-2 439.
30.	［27］Mettlin C, Murphy GP, Babaian RJ. The results of a five-y early prostate cancer detection intervention[J]. Cancer,1996; 77(61): 150-159.
31.	［28］Fowler FJ, Collins MM, Albertsen PC, Zietman A, Alliott DB, Barry MJ. Comparison of recommendations of urologists and radiation oncologists for treatment of clinically localized prostate cancer[J]. JAMA, 2000; 283(7): 3 217-3 222.
32.	［29］Wasson JH, Cushman CC, Bruskewitz RC, Littenberg B, Mulley Jr. AG, Wennberg JE. A structured literature review of treatment for localized prostate cancer[J]. Arch Fam Med,1993; 2(2): 487-493.
33.	［30］Lu-Yao GL, Yao S-L. Population based study of long termsurvival in patients with clinically localised prostate cancer[J]. Lancet , 1997; 349(9 056): 906-910.
34.	［31］Smith DS, Carvalhal GF, Schneider K, Krygiel J, Yan Y, Catalona WJ. Quality-of-life outcomes for men with prostate carcinoma det.ected by screening[J]. Cancer, 2000; 88(16): 1 454-1 463.
35.	［32］Optenberg SA, Thompson IM. Economics of screening for carcinoma of the prostate[J]. Urol Clin NA,1990; 17(4): 719-737.
36.	［33］Catalona WJ, Richie JP, Ahmann FR, Ahmann FR, Hudson MA, et al. Comparison of digital rectal examination and serum prostate specific antigen in the early detection of prostate cancer: results of a multicenter clinical trial of 6,630 men[J]. J Urol, 1994; 151(45): 1 283-1 290.
37.	［34］Svetec D, Thompson IM. PSA screening-current controversy[J]. Ann Oncol,1998; 9: 1 283-1 288.
38.	［35］Benoit RM, Naslund MJ. The economics of prostate cancer screening[J]. Oncology,1997; 11(3): 1 533-1 543.
39.	［36］Grover SA, Zowall H, Coupal L, Krahn MD. Prostate cancer: 12. The economic burden[J]. CMAJ,1999; 160(76): 685-690.
40.	［37］Labrie F, Candas B, Cusan L, Gomez JL, Belanger A, Brousseau G, Chevrette E, Levesque J. Screening decreases prostate cancer mortality: 11-year follow-up of the 1988 Quebec prospective randomized controlled trial[J]. Prostate, 2004; 59(3): 311-318.
41.	［38］Friedman GD, Hiatt RA, Quesenberry CP Jr, Selby JV. Case-control study of screening for prostatic cancer by digital rectal examinations[J]. Lancet,1991; 337(48): 1 526-1 529.
42.	［39］Richert-Boe KE, Humphrey LL, Glass AG, Weiss NS. Screening digital rectal examination and prostate cancer mortality: a case-control study[J]. J Med Screen,1998; 5(2): 99-103.
43.	［40］Jacobsen SJ, Bergstralh EJ, Katusic SK, Guess HA, Darby CH, Silverstein MD, Osterling JE, Lieber MM. Screening digital rectal examination and prostate cancer mortality: a population-based case-control study[J]. Urology,1998; 52(34): 173-179.
44.	［41］Legler JM, Feuer EJ, Potosky AL, Merrill RM, Kramer BS. The role of prostate-specific antigen (PSA) testing patterns in the recent prostate cancer incidence decline in the United States[J]. Cancer Causes Control, 1998; 9(33): 519-527.
45.	［42］Etzioni R, Legler JM, Feuer EJ, Merrill RM, Cronin KA, Hankey BF. Cancer surveillance series: interpreting trends in prostate cancer-part III: Quantifying the link between population prostate-specific antigen testing and recent declines in prostate cancer mortality[J]. J Natl Cancer Inst. 1999; 91(86): 1 033-1 039.
46.	［43］Brawley OW. Prostate carcinoma incidence and patient mortality: the effects of screening and early detection[J]. Cancer,1997; 80(34): 1 857-1 863.
47.	［44］Lu-Yao G, Albertsen PC, Stanford JL, Stukel TA, Walker-Corkery ES, Barry MJ. Natural experiment examining impact of aggressive screening and treatment on prostate cancer mortality in two fixed cohorts from Seattle area and Connecticut[J]. BMJ, 2002; 325(642): 740-745.
48.	［45］Oliver SE, Gunnell D, Donovan JL. Comparison of trends in prostatecancer mortality in England and Wales and the USA[J]. Lancet, 2000; 355(138): 1 788-1 789.
49.	［46］Crocetti E, Ciatto S, Zappa M. Prostate cancer: different incidence but not mortality trends within two areas of Tuscany, Italy[J]. J Natl Cancer Inst, 2001; 93(73): 876-877.
50.	［47］Beemsterboer PMM, de Koning AJ, Kranze R, Trienekens PH, van der Maas PJ, Schroder FH. Prostate specific antigen testing and digital rectal examination before and during a randomized trial of screening for prostate cancer: European Randomized Study of Screening for Prostate Cancer, Rotterdam[J]. J Urol, 2000; 164(32): 1 216-1 220.
51.	［48］Hugosson, J., Aus, G., Becker, C., Carlsson, S., Eriksson, H., Lilja, H., Lodding, P. and Tibblin, G. (2000) Would prostate cancer detected by screening with prostate-specific antigen develop into clinical cancer if left undiagnosed? A comparison of two population-based studies in Sweden[J]. BJU Int, 2000; 85(21): 1 078-1 084.
52.	［49］de Koning HJ, Auvinen A, Berenguer Sanchez AB, Calais da Silva F, Ciatto S, Denis L, Gohagan JK, Hakama M, Hugosson J, Kranse R, Nelen V, Prorok PC, Schroder FH. Large-scale randomized prostate cancer screening trials: program performances in the European Randomized Screening for Prostate Cancer trial and the Prostate, Lung, Colorectal and Ovary cancer trial[J]. Int J Cancer, 2002; 97(11): 237-244.
53.	［50］Wolf AM, Nasser JF, Wolf AM, Schorling JB. The impact of informed consent on patient interest in prostate-specific antigen screening[J]. Arch Intern Med,1996; 156(145): 1 333-1 336.
54.	［51］Volk RJ, Cass AR, Spann SJ. A randomized controlled trial of shared decision making for prostate cancer screening[J]. Arch Fam Med, 1999; 8(14): 333-340.

1. ［1］Hsing A, Tsao L, Devesa S. International trends and patterns of prostate cancer incidence and mortality[J]. Int J Cancer, 2000; 85(1): 60-67.
2. ［2］Liu YT, Li YX, Cheng W. The incidence change of urinary tumor[J]. Journal of Clinical Urology, 1997; 12(6): 4748.
3. 刘耀庭, 李秀霞, 程伟. 泌尿外科肿瘤发病情况的变化[J]. 临床泌尿外科杂志, 1997; 12(6): 47～48.
4. ［3］Gu FL. Epidemiological survey of benign prostatic hyperplasia and prostate cancer in China[J]. Journal of Beijing Medical University, 2000; 32(1): 3033.
5. 顾方六, 我国良性前列腺增生和前列腺癌发病调查[J]. 北京医科大学报, 2000; 32(1): 30～33.
6. ［4］Xu ZB, Wang GM, Sun LA, Zhang YK, The incidence of prostate carcinoma in Shanghai[J]. Clinical Medical Journal of China, 2003; 10(3): 344346.
7. 徐志兵, 王国民, 孙立安, 张永康. 上海市市区前列腺癌发病情况调查分析[J]. 中国临床医学, 2003; 10(3): 344～346.
8. ［5］Von Eschenbach A, Ho R, Murphy GP, Cunningham M, Lins N. American Cancer Society guideline for the early detection of prostate cancer: update 1997[J]. CA Cancer J Clin, 1997; 47(3): 261-264.
9. ［6］Brenda E. Sirovich; Lisa M. Schwartz; Steven Woloshin Screening men for prostate and colorectal cancer in the united states: does practice reflect the evidence?[J]. JAMA, 2003; 289(5): 1 414 -1 420.
10. ［7］Jacobsen SJ, Katusic SK, Berstralh EJ, Oesterling JE. Ohrt D. Klee GG. Chute CG. Lieber MM. Incidence of prostate cancer diagnosis in the eras before and after serum prostate-specific antigen testing[J]. JAMA, 1995; 271(6): 1 445.
11. ［8］Edwards B, Howe H, Ries L, Thun MJ, Rosenberg HM, Yancik R. Annual report to the nation on the status of cancer, 19731999, featuring implications of age and aging on U.S. cancer burden[J]. Cancer, 2002; 94(45): 2 766-2 792.
12. ［9］Brawer MK. Screening for prostate cancer[J]. Sem Surg Oncol 2000; 18(7): 29-36.
13. ［10］W. Sakr, N. Pernick, C. Butler, H. Nassar, V. Pansare, D. Grignon, The prevalence of high grade, clinically occult prostatic adenocarcinoma and its relationship to high grade PIN[M], Abstract 656, American Urological Association, July 2000.
14. ［11］Nam RK, Jewett MAS, Krahn MD. Prostate cancer: 2. Natural history[J].CMAJ,1998; 159(8): 685-691.
15. ［12］Sakr WA, Haas GP, Cassin BJ, Pontes JE, Crissman JD.The frequency of carcinoma and intraepithelial neoplasia of the prostate in young male patients[J]. J Urol, 1993; 150(65): 379-385.
16. ［13］Rosen MA. Impact of prostate-specific antigen screening on the natural history of prostate cancer[J]. Urology, 1995; 46(43): 757-768.
17. ［14］Mistry K. Cable G. Meta-analysis of prostate-specific antigen and digital rectal examination as screening tests for prostate carcinoma[J]. J Am Board Fam Pract. 2003; 16(2): 95-101.
18. ［15］Arjen Hoogendam, Frank Buntinxa, Henrica CW de Vetb. The diagnostic value of digital rectal examination in primary care screening for prostate cancer: a meta-analysis[J]. Family Practice,2003; 16(6): 621-626.
19. ［16］Flanigan RC, Catalona WJ, Richie JP, Ahmann FR, Hudson MA. Accuracy of digital rectal examination and transrectal ultrasonography in localizing prostate cancer[J]. J Urol, 1994; 152(34): 1 506-1 509.
20. ［17］Hammerer P, Huland H. Systematic sextant biopsies in 651 patients referred for prostate evaluation[J]. J Urol,1994; 151(33): 99-102.
21. ［18］Ellis WJ, Chetner MP, Preston SD, Brawer MK. Diagnosis of prostatic carcinoma: the yield of serum prostate specific antigen, digital rectal examination and transrectal ultrasonography[J]. J Urol,1994; 52(2): 1 500-1 525.
22. ［19］Catalona WJ, Smith DS, Ratliff TL, Basler JW. Detection of organ-confined prostate cancer is increased through prostate specific antigen based screening[J]. JAMA,1993; 270(56): 948-954.
23. ［20］Kamoi K, Babaian RJ. Advances in the application of prostate-specific antigen in the detection of early-stage prostate cancer[J]. Sem Oncol, 1999; 26(3): 140-149.
24. ［21］Catalona WJ, Partin AW, Slawin KM. Use of the percentage of free prostatic specific antigen to enhance differentiation of prostate cancer from benign prostatic disease: a prospective multicenter clinical trial[J]. JAMA, 1998; 279(34): 1 542-1 547.
25. ［22］Catalona WJ, Partin AW, Slawin KM. Use of the percentage of free prostatic specific antigen to enhance differentiation of prostate cancer from benign prostatic disease: a prospective multicenter clinical trial[J]. JAMA, 1998; 279(34): 1 542-1 547.
26. ［23］Woodrum DL, Brawer MK, Partin AW, Catalona WJ, Southwick PC. Interpretation of free prostate specific antigen clinical research studies for the detection of prostate cancer[J]. J Urol, 1998; 159(3): 5-12.
27. ［24］Smith DS, Catalona WJ, Herschman JD. Longitudinal screening for prostate cancer with prostate-specific antigen. JAMA, 1996; 276(25): 1 309-1 315.
28. ［25］Keetch DW, Catalona WJ, Smith DS. Serial prostatic biopsies in men with persistently elevated serum prostate specific antigen values[J]. J Urol, 1994; 151(56): 1 571-1 574.
29. ［26］Roehl KA. Antenor JA. Catalona WJ. Serial biopsy results in prostate cancer screening study[J]. J Urol, 2002; 167(6): 2 435-2 439.
30. ［27］Mettlin C, Murphy GP, Babaian RJ. The results of a five-y early prostate cancer detection intervention[J]. Cancer,1996; 77(61): 150-159.
31. ［28］Fowler FJ, Collins MM, Albertsen PC, Zietman A, Alliott DB, Barry MJ. Comparison of recommendations of urologists and radiation oncologists for treatment of clinically localized prostate cancer[J]. JAMA, 2000; 283(7): 3 217-3 222.
32. ［29］Wasson JH, Cushman CC, Bruskewitz RC, Littenberg B, Mulley Jr. AG, Wennberg JE. A structured literature review of treatment for localized prostate cancer[J]. Arch Fam Med,1993; 2(2): 487-493.
33. ［30］Lu-Yao GL, Yao S-L. Population based study of long termsurvival in patients with clinically localised prostate cancer[J]. Lancet , 1997; 349(9 056): 906-910.
34. ［31］Smith DS, Carvalhal GF, Schneider K, Krygiel J, Yan Y, Catalona WJ. Quality-of-life outcomes for men with prostate carcinoma det.ected by screening[J]. Cancer, 2000; 88(16): 1 454-1 463.
35. ［32］Optenberg SA, Thompson IM. Economics of screening for carcinoma of the prostate[J]. Urol Clin NA,1990; 17(4): 719-737.
36. ［33］Catalona WJ, Richie JP, Ahmann FR, Ahmann FR, Hudson MA, et al. Comparison of digital rectal examination and serum prostate specific antigen in the early detection of prostate cancer: results of a multicenter clinical trial of 6,630 men[J]. J Urol, 1994; 151(45): 1 283-1 290.
37. ［34］Svetec D, Thompson IM. PSA screening-current controversy[J]. Ann Oncol,1998; 9: 1 283-1 288.
38. ［35］Benoit RM, Naslund MJ. The economics of prostate cancer screening[J]. Oncology,1997; 11(3): 1 533-1 543.
39. ［36］Grover SA, Zowall H, Coupal L, Krahn MD. Prostate cancer: 12. The economic burden[J]. CMAJ,1999; 160(76): 685-690.
40. ［37］Labrie F, Candas B, Cusan L, Gomez JL, Belanger A, Brousseau G, Chevrette E, Levesque J. Screening decreases prostate cancer mortality: 11-year follow-up of the 1988 Quebec prospective randomized controlled trial[J]. Prostate, 2004; 59(3): 311-318.
41. ［38］Friedman GD, Hiatt RA, Quesenberry CP Jr, Selby JV. Case-control study of screening for prostatic cancer by digital rectal examinations[J]. Lancet,1991; 337(48): 1 526-1 529.
42. ［39］Richert-Boe KE, Humphrey LL, Glass AG, Weiss NS. Screening digital rectal examination and prostate cancer mortality: a case-control study[J]. J Med Screen,1998; 5(2): 99-103.
43. ［40］Jacobsen SJ, Bergstralh EJ, Katusic SK, Guess HA, Darby CH, Silverstein MD, Osterling JE, Lieber MM. Screening digital rectal examination and prostate cancer mortality: a population-based case-control study[J]. Urology,1998; 52(34): 173-179.
44. ［41］Legler JM, Feuer EJ, Potosky AL, Merrill RM, Kramer BS. The role of prostate-specific antigen (PSA) testing patterns in the recent prostate cancer incidence decline in the United States[J]. Cancer Causes Control, 1998; 9(33): 519-527.
45. ［42］Etzioni R, Legler JM, Feuer EJ, Merrill RM, Cronin KA, Hankey BF. Cancer surveillance series: interpreting trends in prostate cancer-part III: Quantifying the link between population prostate-specific antigen testing and recent declines in prostate cancer mortality[J]. J Natl Cancer Inst. 1999; 91(86): 1 033-1 039.
46. ［43］Brawley OW. Prostate carcinoma incidence and patient mortality: the effects of screening and early detection[J]. Cancer,1997; 80(34): 1 857-1 863.
47. ［44］Lu-Yao G, Albertsen PC, Stanford JL, Stukel TA, Walker-Corkery ES, Barry MJ. Natural experiment examining impact of aggressive screening and treatment on prostate cancer mortality in two fixed cohorts from Seattle area and Connecticut[J]. BMJ, 2002; 325(642): 740-745.
48. ［45］Oliver SE, Gunnell D, Donovan JL. Comparison of trends in prostatecancer mortality in England and Wales and the USA[J]. Lancet, 2000; 355(138): 1 788-1 789.
49. ［46］Crocetti E, Ciatto S, Zappa M. Prostate cancer: different incidence but not mortality trends within two areas of Tuscany, Italy[J]. J Natl Cancer Inst, 2001; 93(73): 876-877.
50. ［47］Beemsterboer PMM, de Koning AJ, Kranze R, Trienekens PH, van der Maas PJ, Schroder FH. Prostate specific antigen testing and digital rectal examination before and during a randomized trial of screening for prostate cancer: European Randomized Study of Screening for Prostate Cancer, Rotterdam[J]. J Urol, 2000; 164(32): 1 216-1 220.
51. ［48］Hugosson, J., Aus, G., Becker, C., Carlsson, S., Eriksson, H., Lilja, H., Lodding, P. and Tibblin, G. (2000) Would prostate cancer detected by screening with prostate-specific antigen develop into clinical cancer if left undiagnosed? A comparison of two population-based studies in Sweden[J]. BJU Int, 2000; 85(21): 1 078-1 084.
52. ［49］de Koning HJ, Auvinen A, Berenguer Sanchez AB, Calais da Silva F, Ciatto S, Denis L, Gohagan JK, Hakama M, Hugosson J, Kranse R, Nelen V, Prorok PC, Schroder FH. Large-scale randomized prostate cancer screening trials: program performances in the European Randomized Screening for Prostate Cancer trial and the Prostate, Lung, Colorectal and Ovary cancer trial[J]. Int J Cancer, 2002; 97(11): 237-244.
53. ［50］Wolf AM, Nasser JF, Wolf AM, Schorling JB. The impact of informed consent on patient interest in prostate-specific antigen screening[J]. Arch Intern Med,1996; 156(145): 1 333-1 336.
54. ［51］Volk RJ, Cass AR, Spann SJ. A randomized controlled trial of shared decision making for prostate cancer screening[J]. Arch Fam Med, 1999; 8(14): 333-340.

Chinese Journal of Evidence-Based Medicine

Discussion on Screening for Prostate Cancer

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