降低前列腺癌的风险，你应该知道的信息
What you should know to reduce the risk of prostate cancer
By Dr. Jamin Brahmbhatt, CNN
前列腺癌在我的临床工作中仍然是一个重要的疾病，这就是为什么我强调早期检测的重要性。美国癌症协会估计，到2024年，将有近30万前列腺癌新发病例，约3.5万人死亡。
在诊断和治疗这种常见癌症的过程中，一个重要的工具是前列腺特异性抗原(PSA)测试，这是一种简单的血液测试，为前列腺筛查提供了有价值的信息。到50岁时，男性应该每年做一次PSA检查。如果你有家族病史，或有危险因素，或者你是黑人，你可能需要早在40岁就开始。
什么是前列腺特异性抗原检测?
前列腺特异性抗原检测是前列腺癌早期发现的重要手段。当PSA检查与其他诊断测试和临床评估相结合时，它有助于在早期阶段发现前列腺癌，此时前列腺癌手术和放疗的治疗结果最有可能治愈的机会。
定期PSA筛查对高危人群尤其重要，比如那些有前列腺癌家族史或年龄较大的人。对于每一个男性来说，在接受初级保健医生的年度例行检查时，血液检查也是必不可少的
有什么因素会影响PSA水平?
前列腺肥大、近期的性行为或前列腺感染等情况都可能导致PSA水平升高，从而可能导致不必要的警报。通过将这些因素与PSA测试结果一起考虑，医生可以提供更详细的指导并避免不必要的治疗。
PSA之外的其他筛查方法
随着尿液中的分子检测和血液检测，以及影像学技术的进步，前列腺特异性抗原检测也超越了传统的限制。现在，基于血液和尿液的检测可以精确定位与前列腺癌相关的特定基因标记，可提供每个患者的独特风险档案。
当与传统的PSA检测相结合时，这些血液，尿液的基因检测可以提供更全面的患者前列腺健康情况和癌症风险。这些测试与最初的PSA相结合，可以帮助我们确定谁可能从进一步的调查(如前列腺活检)中获益最多。
前列腺核磁共振技术提供详细的、高分辨率的前列腺图像。它使我们能够识别前列腺内可能藏有前列腺癌的可疑病变。然后使用MRI融合技术定位这些“热点”，在前列腺活检过程中，MRI图像与实时超声图像融合，靶向穿刺这些热点。使用这种成像工具可以在前列腺活检中更准确地检测癌症。
总之，这些联合的测试可以提高我们检测前列腺癌的能力，最终导致更有效和个性化的治疗。
更多针对黑人男性的前列腺癌检测
前列腺癌基金会最近的研究和指导意见强调了，黑人男性前列腺癌筛查的重大更新。认识到黑人患前列腺癌的高风险性，指南建议在40至45岁之间开始检测基线PSA，比其他指南目前的建议更早。
定期筛查，最好每年一次，应该持续到至少70岁。这些更新旨在解决黑人男性前列腺癌预后的差异，提供必要的延长寿命的筛查建议。
根据最近的研究结果，降低黑人男性进行PSA基线检测的推荐年龄，可以将黑人前列腺癌死亡率降低约30%，而不会显著增加过度诊断率。
这样做强调了为高危人群，制定个性化筛查方法的重要性，尤其是黑人男性，他们被诊断患有前列腺癌，并死于前列腺癌的风险是白人男性的两倍。
为所有男性的前列腺健康采取积极的措施。
PSA检测仍然是前列腺癌检测的重要工具，为男性患者提供了早期干预和改善预后的机会。了解最新的筛查指南，和了解个人风险因素是至关重要的。通过优先考虑积极主动的医疗保健措施，并与医生进行当面讨论，男性可以负责自己的前列腺健康，并为减少社区前列腺癌的医疗负担做出贡献。
By Dr. Jamin Brahmbhatt, CNN
CNN —
Prostate cancer remains a significant concern in my practice, which is why I emphasize the importance of early detection. The American Cancer Society estimates there will be nearly 300,000 new cases of prostate cancer and about 35,000 deaths in 2024.
One vital tool in this quest to diagnose and treat this common cancer is prostate-specific antigen, or PSA, testing, which is a simple blood test offering valuable insights into prostate health. By the age of 50, men should be having the test done annually. If you have a family history, have risk factors, or if you are Black, you may need to start as early as age 40.
Prostate-specific antigen testing serves as a cornerstone in the early detection of prostate cancer. When combined with other diagnostic tests and clinical assessments, it aids in identifying prostate cancer in its early stages, when treatment outcomes for prostate cancer surgery and radiation have the best odds for cure.
Regular PSA screenings are particularly crucial for high-risk individuals, such as those with a family history of prostate cancer or advanced age. The blood test is also essential for the average man during his routine annual checkup with his primary care doctor.
Conditions such as an enlarged prostate, recent sexual activity or prostate infections can all contribute to elevated PSA levels, potentially leading to unnecessary alarm. By considering these factors alongside PSA test results, health care providers can provide more informed guidance and avoid unnecessary interventions.
Prostate-specific antigen testing has also evolved beyond its traditional bounds, with advancements in molecular urine and blood tests and imaging technology.
Blood and urine-based tests can now pinpoint specific genetic markers associated with prostate cancer, providing insights into each patient’s unique risk profile.
When combined with traditional PSA testing, these tests offer an even more comprehensive picture of a patient’s prostate health and cancer risk. These tests in combination with the initial PSA can help us determine who may benefit most from further investigation such as a prostate biopsy.
By the age of 50, men should be having prostate-specific antigen, or PSA, testing done annually.
SDI Productions/E+/Getty Images.
Prostate MRI technology offers a detailed, high-definition view of the prostate gland. It enables us to identify suspicious lesions within the prostate gland that could harbor prostate cancer. These “hot spots” are then targeted using MRI fusion technology in which the MRI images are fused to the live ultrasound images during a prostate biopsy. The use of this imaging tool allows for more accurately detecting cancer during a prostate biopsy.
Together, these additional tests can increase our ability to detect prostate cancer, ultimately leading to more effective and personalized treatments.
Recent research and guidelines from the Prostate Cancer Foundation highlight a significant update in prostate cancer screening for Black men. Recognizing their heightened risk, the guidelines recommend initiating baseline PSA testing between ages 40 and 45, earlier than current recommendations from other organizations. Regular screenings, preferably annually, should continue until at least age 70. These updates aim to address disparities in prostate cancer outcomes among Black men, offering essential lifesaving screening recommendations.
Lowering the recommended age for baseline PSA testing in Black men could reduce prostate cancer deaths by about 30% without significantly increasing overdiagnosis rates, according to recent findings. Doing so emphasizes the importance of tailored screening approaches for high-risk populations, particularly Black men, who are about two times more likely to be diagnosed with and die from prostate cancer than White men.
The PSA test remains a critical tool in prostate cancer detection, offering men an opportunity for early intervention and improved outcomes. Staying informed about updates in screening guidelines and understanding individual risk factors is vital. By prioritizing proactive health care and engaging in open discussions with health care providers, men can take charge of their prostate health and contribute to reducing the burden of prostate cancer in our communities.
