Читать книгу Pathy's Principles and Practice of Geriatric Medicine - Группа авторов - Страница 272

The biggest controversy in prostate screening is that some prostate cancers grow slowly and would never cause any problems.³⁷ Because of an elevated prostate‐specific antigen (PSA) test, men may be diagnosed and treated for prostate cancer with either surgery or radiation for lesions that would not cause symptoms or lead to their death. These treatments have side effects that can seriously affect a man’s quality of life. No major scientific or medical organization, including the ACS, American Urologic Association (AUA), USPSTF, American Academy of Family Physicians, and American College of Preventive Medicine, supports routine testing for prostate cancer at this time.³⁵

The ACS recommends that beginning at age 50, men who are at average risk of prostate cancer and have a life expectancy of at least 10 years have a conversation with their healthcare provider about the benefits and limitations of PSA testing and make an informed decision about whether to be tested based on their personal values or preferences.³⁵ The NCCN guidelines focus on men at an increased risk for developing prostate cancer due especially to family history and race and state that PSA testing should only be offered to men with a life expectancy of 10 or more years.⁴¹ The USPSTF recommends against prostate cancer screening in men 70 and older.⁴¹ These organizations emphasize the need for healthcare professionals to discuss with the male patient the possible benefits and side effects of treatment and answer questions about early prostate cancer detection. Therefore, men who are at least 50 (and younger, if at higher risk) can make informed decisions, taking into account their own situations.