Based on the GLOBOCAN statistics 2023, prostate cancer is the first and most commonly diagnosed cancer and the second cause of cancer death in men, with estimated 288 300 new cancer cases and 34 700 deaths.1 Interesti...Based on the GLOBOCAN statistics 2023, prostate cancer is the first and most commonly diagnosed cancer and the second cause of cancer death in men, with estimated 288 300 new cancer cases and 34 700 deaths.1 Interestingly, the incidence rate of prostate cancer decreased around 40% from 2007 to 2014. This reflects the recommendation of the United States Preventive Services Task Force (USPSTF) to avoid prostate-specific antigen (PSA) testing screening for ≥75 years old men in 2008 and for all men in 2012.1 In the 1990s, PSA testing for screening purpose was widely adopted. In a few years, considering how common prostate cancer is, many issues related to overdiagnosis and overtreatment of early detected localized prostate cancer raised in scientific community.2 Several studies showed that patients with early moderately and highly differentiated prostate cancer who did not undergo local treatment have a low death rate. Considering that curative treatment options such as surgery or radiotherapy are at risk of significant side effects, definition of deferred treatment approach for those patients started to become a medical need. Two different conservative approaches with different goals and inclusion criteria are considered with the aim to reduce overtreatment: active surveillance (AS) and watchful waiting (WW), as shown in Table 1. In this opinion, we will focus on AS.3,4.展开更多
文摘Based on the GLOBOCAN statistics 2023, prostate cancer is the first and most commonly diagnosed cancer and the second cause of cancer death in men, with estimated 288 300 new cancer cases and 34 700 deaths.1 Interestingly, the incidence rate of prostate cancer decreased around 40% from 2007 to 2014. This reflects the recommendation of the United States Preventive Services Task Force (USPSTF) to avoid prostate-specific antigen (PSA) testing screening for ≥75 years old men in 2008 and for all men in 2012.1 In the 1990s, PSA testing for screening purpose was widely adopted. In a few years, considering how common prostate cancer is, many issues related to overdiagnosis and overtreatment of early detected localized prostate cancer raised in scientific community.2 Several studies showed that patients with early moderately and highly differentiated prostate cancer who did not undergo local treatment have a low death rate. Considering that curative treatment options such as surgery or radiotherapy are at risk of significant side effects, definition of deferred treatment approach for those patients started to become a medical need. Two different conservative approaches with different goals and inclusion criteria are considered with the aim to reduce overtreatment: active surveillance (AS) and watchful waiting (WW), as shown in Table 1. In this opinion, we will focus on AS.3,4.
