Oportunistic screening and deferred treatment as options for improving quality of care of prostate cancer patients

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Aleksandra Zachariasz, Wojciech Wysoczański

3 (60) 2019 s. 238–242
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DOI: https://doi.org/10.20883/ppnoz.2019.54

Fraza do cytowania: Zachariasz A., Wysoczański W. Oportunistic screening and deferred treatment as options for improving quality of care of prostate cancer patients. Polski Przegląd Nauk o Zdrowiu. 2019;3(60):238–242. DOI: https://doi.org/10.20883/ppnoz.2019.54

Prostate cancer (PCa), as well as other cancers, is an increasing health problem with a  significant economic and social impact. In Poland PCa is the most common cause of cancer and the second leading cause of death among men. In general, the purpose of cancer screening is early detection resulting in reduction of mortality. However, PCa population-based screening for prostate specific antigen (PSA) test may lead to overdiagnosis, i.e. detection of clinically insignificant tumors. Precisely for this reason, guidelines on PCa recommend opportunistic screening, performed only in group of patients with increased risk of PCa. In many diagnosed men, particularly with low-risk PCa, radical or pharmacological treatment is not necessary and may lead to serious side-effects reducing patients quality of life. For these patients recommended management option is deferred therapy, such as active surveillance (AS) and watchful waiting (WW), which are applied in accordance with the patient’s life expectancy. The  underlining idea of AS and WW is patient’s monitoring until the moment that interventional treatment is necessary. Application of these two methods can reduce PCa overtreatment. In  countries with high-quality medical care system, such as Sweden, AS and WW have become commonly used options. Introduction of opportunistic screening for PCa in Poland requires concurrent implementation of AS and WW to the health system. However, before implementation prior establishment of reliable medical data registries and quality indicators is needed. Such changes might help to improve quality of healthcare of PCa patients.

Key words: prostate cancer, screening, watchful waiting, active surveillance.

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