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Sinnhaftigkeit des PSA-Screenings

Meaningfulness of PSA screening

  • Leitthema
  • Published:
Der Onkologe Aims and scope

Zusammenfassung

Hintergrund

Kaum ein Krebsfrüherkennungsverfahren ist so umstritten wie der PSA-Test. Seit der gleichzeitigen Veröffentlichung der Ergebnisse der europäischen und US-amerikanischen PSA-Screening-Studie im Jahr 2009 wird die Sinnhaftigkeit des PSA-Screenings in der Fachwelt heftig diskutiert. Die z. T. auf diesen Studienergebnissen basierende Empfehlung der US-amerikanischen Preventive Services Task Force (USPSTF) gegen den Einsatz des PSA-Tests im Jahr 2012 hat diese Diskussion weiter verschärft und dazu geführt, dass sich auch öffentliche Medien dieses Themas angenommen haben. Das grundsätzliche und oftmals unkritische in Zweifel ziehen des PSA-Tests, z. T. gepaart mit plakativen Formulierungen, haben zahlreiche Männer, die an einer Früherkennung interessiert sind, verunsichert.

Ziel

Der vorliegende Beitrag soll die Vor- und Nachteile des PSA-Screenings kritisch beleuchten und im letzten Teil einen groben Ausblick auf neue diagnostische Ansätze geben.

Methode

Es wurde eine semistrukturierte Literatursuche in Pubmed bis 2016 durchgeführt.

Schlussfolgerung

Risikoadaptierte Ansätze zum PSA-Screening könnten den Ausweg aus dem Dilemma der PSA-basierten Prostatakrebsfrüherkennung darstellen.

Abstract

Background

There is barely no other procedure for early cancer detection that is so controversially discussed as the prostate-specific antigen (PSA) test. Since the simultaneous publication of the results of the European and American PSA screening studies in 2009, the meaningfulness of PSA screening has been fiercely discussed. The recommendations of the U.S. Preventive Services Task Force (USPSTF) against the use of the PSA test in 2012, which are partly based on the study results, rekindled and intensified the discussion and led to the public media becoming involved in this topic. The fundamental and often uncritical casting of doubts on the PSA test partly paired with bold phrasing, have made many men who were interested in an early recognition uncertain.

Aim

This article provides a critical review of the advantages and disadvantages of PSA screening and discusses future recommendations regarding a risk-adapted screening program.

Methods

Semistructered literature search in PubMed until 2016.

Conclusion

Risk-adapted approaches to PSA screening could overcome the dilemma of population-based prostate cancer screening programs.

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Authors and Affiliations

  1. Universitätsklinikum Düsseldorf, Medizinische Fakultät, Heinrich-Heine Universität Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland

    Christian Arsov &  Peter Albers

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  1. Christian Arsov
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  2. Peter Albers
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Correspondence to Peter Albers.

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C. Arsov und P. Albers geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Arsov, C., Albers, P. Sinnhaftigkeit des PSA-Screenings. Onkologe 23, 429–437 (2017). https://doi.org/10.1007/s00761-017-0205-y

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