Tijdschrift voor Urologie

, Volume 2, Issue 8, pp 184–189

Risicostratificatie en vroege opsporing van prostaatkanker

Risicostratificatie en vroege opsporing van prostaatkanker
  • M.J. Roobol
Article

Samenvatting

Vroege opsporing van prostaatkanker is controversieel, omdat met de huidige beschikbare tests de kosten, in dit geval de lasten voor de patiënt, nog niet opwegen tegen de baten. Het sleutelwoord is risicostratificatie, hoe kunnen we díe mannen identificeren die echt baat hebben bij vroege opsporing van hun prostaatkanker?

Op basis van de serum PSA-test is een eerste risicostratificatie mogelijk, maar het in evenwicht brengen van de lasten en baten vraagt om een multivariate aanpak, waarbij inclusie van informatie over het prostaatvolume cruciaal is. Naast een risicostratificatie is wetenschappelijk betrouwbare informatie over de gevolgen van vroege opsporing van prostaatkanker uitermate belangrijk om gezamenlijk, de (potentiële) patiënt en de behandelend arts, tot een besluit te komen.

Trefwoorden:

prostaatkanker, PSA, vroege opsporing, risicostratificatie 

Summary

Risk stratification and early detection of prostate cancer

Prostate cancer screening is still a controversial issue. The 20-30% disease specific mortality reduction that can be achieved by systematic PSA based screening coincides with major drawbacks, such as unnecessary testing and overdiagnosis that need to be reduced. Thus, the most important question to solve is: how can we identify those men that can benefit from the early detection of prostate cancer? The key word is risk stratification.

Risk stratification based on a serum PSA test is possible, yet not enough to balance the benefits and drawbacks. To achieve a balance, a multivariate approach is recommended in which including information on prostate volume is crucial. In addition to effective risk stratification, balanced information on the pros and cons of PSA based prostate cancer screening is essential to reach shared patient-physician decision making.

Keywords:

Prostate cancer, PSA, Early detection, Risk stratification 

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Copyright information

© Bohn Stafleu van Loghum 2012

Authors and Affiliations

  • M.J. Roobol
    • 1
  1. 1.afdeling Urologie Erasmus Medisch CentrumuroloogRotterdamNetherlands

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