研究动态
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全球观点:撒哈拉以南非洲前列腺癌的最新进展。

Global Viewpoints: Updates on Prostate cancer in Sub-Saharan Africa.

发表日期:2023 Sep 13
作者: Mohamed Jalloh, Ayun Cassell, Lamine Niang, Timothy Rebbeck
来源: BJU INTERNATIONAL

摘要:

前列腺癌是撒哈拉以南非洲(SSA)的一个重大健康问题,发病率和死亡率较高。然而,在SSA地区,广泛使用的前列腺特异性抗原(PSA)筛查在可获得性和负担能力上存在问题。目前正在探索替代筛查策略,如风险分层方法和成本效益的PSA测试,以便针对高危人群并改善筛查的可及性。由于缺乏诊断工具和有限的医疗资源,前列腺癌在SSA的诊断存在挑战。临床评价和数字直肠检查(DRE)是常用的方法,但PSA测试、磁共振成像(MRI)和活检通常有限。因此,许多SSA男性在疾病晚期被诊断出来。SSA地区的前列腺癌治疗选择通常受到资源和培训的医疗提供者不足的限制。虽然手术、放射治疗和雄激素剥夺疗法是可行的,但可能无法为许多患者提供。文化信仰和对前列腺癌的污名进一步影响治疗决策。改善患者和社区的认知,电子病历以及医患之间的沟通能够增强基于证据的决策,并提倡政策变化。了解遗传决定因素并实施综合策略可以改善结果,并更好地控制SSA地区的前列腺癌。本文受版权保护。版权所有。
Prostate cancer is a major health concern in Sub-Saharan Africa (SSA), with high incidence and mortality rates. However, the widely used prostate-specific antigen (PSA) screening is not readily available or affordable in SSA. Alternative screening strategies, such as risk stratification approaches and cost-effective PSA tests, are being explored to target high-risk individuals and improve access to screening. Diagnosis of prostate cancer in SSA is challenging due to the lack of access to diagnostic tools and limited healthcare resources. Clinical evaluation and digital rectal examination (DRE) are commonly used, but PSA testing, magnetic resonance imaging (MRI), and biopsy are often limited. As a result, many men in SSA are diagnosed at advanced stages of the disease. Treatment options for prostate cancer in SSA are often limited by a lack of resources and trained healthcare providers. Surgery, radiation therapy, and androgen deprivation therapy are available but may be inaccessible to many patients. Cultural beliefs and stigma surrounding prostate cancer further impact treatment decisions. Improved patient and community awareness, electronic medical records, and communication between patients and healthcare professionals can enhance evidence-based decision-making and advocate for policy changes. Understanding the genetic determinants and implementing comprehensive strategies can lead to improved outcomes and better control of prostate cancer in SSA.This article is protected by copyright. All rights reserved.