Consensus Points of Chinese Experts on Prostate Cancer Screening (2021 Edition)

In recent years, the incidence of prostate cancer in China has shown a significant upward trend, and it is gradually becoming an important disease affecting the health of middle-aged and elderly men in China
.

Data from multi-center studies in China show that only one-third of newly diagnosed prostate cancer patients are clinically localized prostate cancer, and most patients are already in the middle and advanced stages when they are first diagnosed.
As a result, the overall prognosis of Chinese prostate cancer patients is far worse than that of Western developed countries
.

"Early screening, early diagnosis, and early treatment" is one of the effective methods to improve the 5-year survival rate of cancer patients
.

Studies have shown that in countries that implement prostate cancer screening strategies, such as Japan, the 5-year survival rate of prostate cancer patients has increased rapidly, with an average annual increase of about 11.
7%, and the 5-year survival rate has reached 93.
0%, while China’s annual increase is only 3.
7%, 5 The annual survival rate is only 69.
2%
.

Therefore, screening, early diagnosis and treatment of high-risk groups are effective means to improve the overall survival rate of Chinese prostate cancer patients
.

The purpose and significance of the consensus on prostate cancer screening: increase the detection rate of prostate cancer in high-risk groups and detect early prostate cancer
.

Reduce the prostate cancer mortality of the screening population without affecting the quality of life of the screening population
.

Prostate cancer screening methods: 1.
It is recommended to perform regular serum PSA testing; 2.
It is not recommended to use PCA3 testing, p2PSA testing, 4Kscore, prostate health index, MRI examination, etc.
as routine methods of prostate cancer screening; 3.
Carry out screening activities At the time, the subjects’ serum samples can be collected and stored centrally and then brought back to the hospital for uniform PSA testing, or a portable PSA testing instrument can be used for rapid testing (microfluidic technology, fluorescence immunochromatography, etc.
)
.

It should be noted that the results of the rapid PSA test are only used as a reference for initial screening, not as a basis for disease diagnosis.
Subjects need to be referred to the hospital for retesting and confirmation of PSA
.

Prostate cancer screening population: 1.
Perform prostate cancer screening based on serum PSA test for men who are in good physical condition and have a life expectancy of more than 10 years; 2.
Serum PSA test is performed every 2 years, according to the age of the subject And physical conditions determine the termination time of PSA testing; 3.
Serum PSA testing should be carried out as soon as possible for people at high risk of prostate cancer.
High-risk groups include: men aged >50 years; men aged >45 years with a family history of prostate cancer; age> Males with PSA>1 μg/L at 40 years old; males with BRCA2 gene mutation and age>40 years old
.

Follow-up after PSA screening: PSA≥4μg/L was defined as an abnormal value
.

When the subject’s PSA is less than 4 μg/L, it is recommended to follow up once every two years; when the subject’s PSA is ≥ 4 μg/L, the subject or family members should be notified in time, and the subject is advised to switch Go to the hospital for further diagnosis, treatment and follow-up
.

  Prostate cancer screening pathway PSA abnormal population referral pathway source: Chinese Anti-Cancer Association Urinary and Male Reproductive System Tumor Professional Committee Prostate Cancer Group.
Chinese Expert Consensus on Prostate Cancer Screening (2021 Edition)[J].
Chinese Journal of Cancer, 2021, 31(5): 435-440.