前列腺癌 ( prostatecancer ,PC)是欧美常见男性恶性肿瘤 ,在我国发病率也逐年增加 ,成为威胁老年男性生命的重要疾病。由于缺乏可干预的危险因素 ,早发现、早治疗作为降低前列腺癌死亡率的策略被寄予厚望。现有筛查手段为联合血清前列腺特异性抗原 (PSA)测定和直肠指检。目前在普通人群是否进行筛查试验还有争论 ,缺乏筛查能降低死亡率的一级证据 ,且发现的PC最终是否发展为临床疾病也有疑问。现有对早期局限性癌的 3种治疗方法 (观察等待、外照射和外科切除 )缺乏有力的随机对照试验 (RCT)证据来证实其利弊。在缺乏筛查试验RCT结果的情况下 ,大多数医生推荐进行“知情同意”的筛查 ,即让医生和患者都充分了解和讨论可供选择的早期诊断方法以及筛查的利弊后再做决定 Prostate cancer (prostatecancer, PC) is a common malignant tumor in Europe and the United States, the incidence in our country also increased year by year, becoming an important disease threatening the life of older men. Due to the lack of interventional risk factors, early detection and early treatment are expected as strategies to reduce the mortality of prostate cancer. Existing screening methods for the combination of serum prostate-specific antigen (PSA) determination and digital rectal examination. There is still debate in the general population whether screening tests are conducted, a lack of first-class evidence of screening to reduce mortality, and questions as to whether the discovery of PC eventually progresses to clinical disease. There are no valid randomized controlled trials (RCTs) of the three treatments for early localized cancer (observation waiting, external beaming, and surgical resection) to confirm their pros and cons. In the absence of RCT results, most doctors recommend “informed consent” screening, which allows both doctors and patients to fully understand and discuss the options available for early diagnosis and the pros and cons of screening