계명대학교 의학도서관 Repository

Should Contemporary Western Guidelines Based on Studies Conducted in the 2000s Be Adopted for the Prostate-Specific Antigen Screening Policy for Asian Men in the 2020s?

Metadata Downloads
Author(s)
Young Hwii KoByung Hoon Kim
Keimyung Author(s)
Kim, Byung Hoon
Department
Dept. of Urology (비뇨의학)
Journal Title
World J Mens Health
Issued Date
2022
Volume
40
Issue
4
Keyword
AgingProstate cancerProstate-specific antigenScreening
Abstract
Though prostate cancer (PCa) is the second most common cancer world widely, there exist substantial differences exist between Asia and the west. Genetic susceptibility and lifestyle may contribute to disproportionately lower incidences and mortalities of PCa in Asian countries, but the differences in diagnostic practices are also likely to contribute, and a large part of them may be explained by the lesser chance of prostate-specific antigen (PSA) testing. In the US, about half of men aged over 50 years had been exposed to the screening test in the early 2000s. The shifts in the risk stratification from the high-risk dominant disease in the late 1980s to the low-risk dominant disease in the early 2000s led to criticism regarding the unconditional nature of PSA-based screening. Based on the conflicting outcomes from the randomized clinical trials which investigated the benefit of PSA testing, US Preventive Study Task Force recommended ceasing mass screening in 2012. Accordingly, guidelines begin to emphasize shared decision-making on the PSA testing narrowing their scopes to men aged 55 to 69 years since 2013. Though most Asian countries have not begun to recognize PCa as a major agenda item until the 2010s, a clear trend of expanding incidence of it implies that the time to come to reconsider PSA testing as a higher priority in the public health sphere in the 2020s. Concerns regarding over-diagnosis and over-treatment of insignificant diseases are imperative. However, the distinctive epidemiologic characteristics of PCa in Asia areas, such as low exposure to the repetitive PSA testing, the recent increase in its incidence driven by the elderly and super-elderly, and racial differences should be considered when it comes to the establishment of screening policy utilizing PSA test.
Keimyung Author(s)(Kor)
김병훈
Publisher
School of Medicine (의과대학)
Type
Article
ISSN
2287-4690
Source
https://wjmh.org/DOIx.php?id=10.5534/wjmh.220002
DOI
10.5534/wjmh.220002
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/44479
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Urology (비뇨의학)
Authorize & License
  • Authorize공개
Files in This Item:

Items in Repository are protected by copyright, with all rights reserved, unless otherwise indicated.