摘要

拜登总统确诊前列腺癌，引发对这一常见但争议性疾病的关注。美国每八名男性中就有一人患此病，前列腺癌发病率居全国第二。年龄虽是主因，但如奥运自行车手克里斯·霍伊48岁确诊的案例，促使人们讨论是否应扩大中年男性的筛查范围。然而，PSA检测因假阳性率高达75%、假阴性率15%而备受质疑，常导致不必要活检。过度诊断问题突出，因多数肿瘤生长缓慢，未必需即刻治疗。激进疗法可能引发失禁、阳痿等永久副作用。对局部癌症，主动监测效果相当。面对MRI和基因组学等进步，医学界对筛查意见不一，强调个体化决策。

President Biden's prostate cancer diagnosis highlights a common yet contentious disease. Affecting 1 in 8 men, prostate cancer ranks as America’s second-most prevalent cancer. While age is the primary risk factor, high-profile cases like Olympic cyclist Chris Hoy (diagnosed at 48) fuel debates on expanding screening for middle-aged men. However, widespread PSA testing faces skepticism: its 75% false-positive and 15% false-negative rates lead to unnecessary biopsies. Overdiagnosis is a major concern, as many tumors grow slowly and may not require immediate intervention. Aggressive treatments risk permanent side effects like incontinence and impotence. Active surveillance is often equally effective for localized cancer. Medical bodies disagree on screening guidelines, advising individualized decisions amid evolving diagnostics like MRI and genomics.