[详情]
答案：E. 监测
患者为多种并发症的老年男性，预期寿命不超过10年。2012年，美国预防服务组（USPSTF）建议指出，筛查和治疗试验对超过70岁的男性人群而言意义不大。[11] 2014年，在美国国立综合癌症网络（NCCN）指南中提到，前列腺癌早期检查发现，75岁以上男性很少从PSA检测中受益，NCCN建议年龄超过70岁的男性人群，应谨慎选择筛查试验，仅仅建议这个年龄组中很少或无并发症的健康男性进行此类试验。[6] NCCN强调，临床医生应考虑对高风险癌症人群采取较高PSA临界值，如对超过70岁男性采用PSA临界值>4ng/mL，75岁PSA值为3ng/mL。[6]
该图显示了2014年NCCN指南中前列腺癌早期检测及活检的适应症。
参考文献
6.National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology. Prostate cancer early detection. V1.2014. March 10, 2014. Available at: http://www.nccn.org/professionals/physician_gls/PDF/prostate_detection.pdf. Accessed April 15, 2015.
7.National Cancer Institute. Cancer snapshots: disease focused and other snapshots. A snapshot of prostate cancer. November 5, 2014. Available at: http://www.cancer.gov/researchandfunding/snapshots/prostate. Accessed April 15, 2015.
8.National Cancer Institute. Digital rectal examination and prostate-specific antigen. April 2, 2015. Available at: http://www.cancer.gov/cancertopics/pdq/screening/prostate/HealthProfessional. Accessed April 15, 2015.
9.Harvard Medical School. Harvard Health Publications. PSA: prostate-specific antigen, persisting scientific ambiguities. July 2009. Available at: http://www.health.harvard.edu/newsletters/Harvard_Mens_Health_Watch/2009/July/PSA-Prostate-Specific-Antigen-Persisting-Scientific-Ambiguities. Accessed April 15, 2015.
10.National Cancer Institute. Prostate cancer treatment (PDQ). Health professional version. February 25, 2015. Available at: http://www.cancer.gov/cancertopics/pdq/treatment/prostate/HealthProfessional. Accessed April 15, 2015.
11.Moyer VA, US Preventive Services Task Force. Screening for prostate cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2012;157(2):120-34. PMID: 22801674
