Improving prostate cancer screening and diagnosis: Health policy and biomarkers beyond PSA
Menée sur 499 patients présentant un niveau sérique du PSA entre 2 et 20 ng/ml, puis validée sur 1 064 patients complémentaires, cette étude évalue la performance d'un test urinaire, basé sur la recherche de l'expression de gènes de l'exosome, pour estimer la probabilité de détecter à la biopsie un cancer de la prostate de haut grade
The initial goal of prostate cancer screening with prostate-specific antigen (PSA) was to identify men with early-stage disease according to the general oncologic principle of secondary prevention that early diagnosis and treatment would prevent disease progression and improve survival. However, 2 randomized clinical trials evaluating PSA screening and a large body of literature have identified unintended harms of overdiagnosis and overtreatment of potentially indolent prostate cancer.1,2 The revised US Preventive Services Task Force grade D recommendation for PSA screening in 2012, stating that there is a lack of evidence that its benefits outweigh its harms, further thrust prostate cancer screening into the spotlight of health policy in the United States.3
JAMA Oncology , éditorial, 2015