首页 中华肿瘤杂志 2022年44卷01期 中国前列腺癌筛查与早诊早治指南(2022，北京)
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中国前列腺癌筛查与早诊早治指南(2022，北京)
赫捷 
陈万青
李霓
曹巍
叶定伟
马建辉
邢念增
彭绩
田金徽
中国前列腺癌筛查与早诊早治指南制定专家组
中国前列腺癌筛查与早诊早治指南制定工作组
作者及单位信息
·
DOI： 10.3760/cma.j.cn112152-20211226-00975
China guideline for the screening and early detection of prostate cancer (2022, Beijing)
He Jie
Chen Wanqing
Li Ni
Cao Wei
Ye Dingwei
Ma Jianhui
Xing Nianzeng
Peng Ji
Tian Jinhui
China Prostate Cancer Screening and Early Diagnosis and Early Treatment Guidelines Development Expert Group
Working Group on Formulation of Guidelines for Prostate Cancer Screening, Early Diagnosis and Early Treatment in China
Authors Info & Affiliations
He Jie
National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Chen Wanqing
National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Li Ni
National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Cao Wei
National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Ye Dingwei
Fudan University Shanghai Cancer Center, Shanghai 200032, China
Ma Jianhui
National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Xing Nianzeng
National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Peng Ji
Shenzhen Center for Chronic Disease Control and Prevention, Shenzhen 518020, China
Tian Jinhui
Evidence-Based Medicine Center of Lanzhou University, Lanzhou 730000, China
China Prostate Cancer Screening and Early Diagnosis and Early Treatment Guidelines Development Expert Group
Working Group on Formulation of Guidelines for Prostate Cancer Screening, Early Diagnosis and Early Treatment in China
·
DOI： 10.3760/cma.j.cn112152-20211226-00975
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摘要
前列腺癌是好发于老年男性的生殖系统恶性肿瘤。前列腺癌高风险人群筛查与患者的早诊早治对提高前列腺癌治愈率至关重要。制定符合中国国情的前列腺癌筛查与早诊早治指南，将促进中国前列腺癌筛查的同质性和规范性，提高前列腺癌筛查的效果。中国前列腺癌筛查与早诊早治指南受国家卫生健康委员会疾病预防控制局委托与指导，由国家癌症中心发起，联合多学科专家，根据《世界卫生组织指南制定手册》的原则和方法，整合近年来国内外在前列腺癌筛查与早诊早治方面的新进展，同时考虑中国前列腺癌筛查的实际经验，针对前列腺癌筛查对象、技术、流程、质控等15个关键问题给出了详细的循证推荐，旨在规范前列腺癌筛查与早诊早治实践，提升中国前列腺癌防控效果。
前列腺肿瘤;筛查;早诊早治;指南;中国
ABSTRACT
Prostate cancer (PC) is one of the malignant tumors of the genitourinary system that occurs more often in elderly men. Screening, early diagnosis, and treatment of the PC high risk population are essential to improve the cure rate of PC. The development of the guideline for PC screening and early detection in line with epidemic characteristics of PC in China will greatly promote the homogeneity and quality of PC screening. This guideline was commissioned by the Bureau of Disease Control and Prevention of the National Health Commission. The National Cancer Center of China initiated and convened a working group comprising multidisciplinary experts. This guideline strictly followed the World Health Organization Handbook for Guideline Development and combined the most up-to-date evidence of PC screening, China′s national conditions, and practical experience in cancer screening. A total of fifteen detailed evidence-based recommendations were provided with respect to the screening population, technology, procedure management, and quality control in the process of PC screening. This guideline aimed to standardize the practice of PC screening and improve the effectiveness and efficiency of PC prevention and control in China.
Prostate neoplasms;Screening;Early diagnosis and treatment;Guideline;China
He Jie, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China, Email:
nc.defcaab.smaciceijeh
He Jie and Chen Wanqing contributed equally to this article
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引用本文
赫捷,陈万青,李霓,等. 中国前列腺癌筛查与早诊早治指南(2022，北京)[J]. 中华肿瘤杂志,2022,44(01)：29-53.
DOI:10.3760/cma.j.cn112152-20211226-00975PERMISSIONS
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一、引言
前列腺癌是老年男性泌尿生殖系统常见的恶性肿瘤之一，其发病率和死亡率分别位列全球男性恶性肿瘤发病和死亡谱的第2位和第5位，在欧美国家男性中分别居首位和第3位，在中国男性中分别居第6位和第7位
[
1
]。近年来，随着中国人口老龄化加剧等原因，前列腺癌的发病和死亡呈明显上升趋势，疾病负担日益加重
[
2
,
3
]。GLOBOCAN2020数据显示，中国前列腺癌发病数和死亡数分别占全球前列腺癌发病数和死亡数的8.2%和13.6%
[
4
]。前列腺癌严重威胁我国男性人群身心健康，是我国重要公共卫生问题之一。
前列腺癌患者的生存时间与其临床诊断时恶性肿瘤分期密切相关。我国前列腺癌初诊病例以临床中晚期居多，临床局限性病例仅为30%，导致我国前列腺癌患者的总体预后较差
[
5
]。2003—2015年间，我国前列腺癌年龄标化5年生存率从53.8%上升到66.4%，但与发达国家男性前列腺癌总体5年生存率相比仍有较大差距
[
6
]。美国监测、流行病学和最终结果数据库2010—2016年数据显示，临床局限性前列腺癌患者在接受标准化治疗后5年生存率接近100%，而转移性前列腺癌患者5年生存率仅为30%
[
7
]。由于前列腺癌发病隐匿、进展较慢，因此，对高风险人群进行前列腺癌筛查，发现早期前列腺癌患者并予以规范化治疗，是改善我国前列腺癌患者预后的重要手段。
当前，在全面推进"健康中国行动"的战略背景下，国务院明确提出要加强恶性肿瘤早期筛查，制定并推广专业技术指南，有序扩大筛查范围
[
8
]。国家癌症中心积极响应国家癌症防控战略部署并推进癌症筛查与早诊早治。由于我国缺乏统一的前列腺癌筛查技术规范，以及民众对于前列腺癌及其筛查的认知程度低等现状，制约着我国前列腺癌筛查与早诊早治工作的效果。为了推进我国前列腺癌筛查的规范化、优质化和均质化，为筛查相关工作人员尤其是基层工作人员提供科学的、可操作性强的前列腺癌筛查指导，《中国前列腺癌筛查与早诊早治指南(2022，北京)》(以下简称《指南》)基于国内外前列腺癌筛查相关研究进展、专家共识、指南规范、筛查项目经验及我国实际国情，重点针对高风险人群、筛查技术、组织要求、筛查流程及结果管理等方面进行归纳整合，提出适宜我国前列腺癌筛查的推荐意见。
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备注信息
A
赫捷，国家癌症中心 国家肿瘤临床医学研究中心 中国医学科学院北京协和医学院肿瘤医院，北京 100021, Email:
nc.defcaab.smaciceijeh
B
赫捷和陈万青对本文有同等贡献
C
指南制定总顾问：指南发起、研究指导；指南制定专家组组长：组织领导、研究指导、指南审阅；指南制定专家组成员：遴选关键问题、专家共识、指南审阅；指南制定工作组成员：证据检索与评价、校对修订；主要执笔团队：执笔撰写、证据检索与评价、校对修订
D
指南制定工作组感谢以下专家在本指南制定过程中提出的宝贵建议(按姓氏汉语拼音字母排序)：杜灵彬(浙江省肿瘤医院)、龚继勇(山东省肿瘤医院)、贺宇彤(河北医科大学第四医院)、邱建星(北京大学第一医院)、孙喜斌(河南省肿瘤医院)、王慜杰(国家癌症中心 国家肿瘤临床医学研究中心 中国医学科学院北京协和医学院肿瘤医院)、王宁(北京大学肿瘤医院)、王庆生(天津市肿瘤医院)、魏少忠(湖北省肿瘤医院)、徐涛(北京大学人民医院)、严维刚(北京协和医院)、杨飞亚(国家癌症中心 国家肿瘤临床医学研究中心 中国医学科学院北京协和医学院肿瘤医院)
E
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