Xing Nianzheng, Vice President of the Cancer Hospital of the Chinese Academy of Medical Sciences: Integrating Early Screening and Management to Improve the Therapeutic Effect of Prostate Cancer Diagnosis and Treatment

2024-06-17

According to the latest data released by the World Health Organization Cancer Research Institute, prostate cancer is the second most common cancer among men in the world, and has become the highest incidence rate malignant tumor in China's male urinary system for many consecutive years. According to the latest data of the Chinese Cancer Burden Report released by the National Cancer Center, in 2022, there will be 134200 new cases of prostate cancer in China, 47500 deaths from prostate cancer, and both the incidence rate and mortality will continue to rise. "China's aging population and the low rate of early visits are important reasons for the increasing incidence rate and mortality of prostate cancer, and the cost of early treatment is far lower than that of late treatment." Recently, Xing Nianzheng, Vice President of the Cancer Hospital of the Chinese Academy of Medical Sciences, stated in an interview with reporters that efforts should be made to strengthen the promotion and education of early screening and diagnosis of prostate cancer, provide cancer prevention and standardized treatment knowledge to high-risk groups of prostate cancer, popularize knowledge of prostate cancer, enhance public enthusiasm and compliance with prostate cancer screening, and care for the health of middle-aged and elderly men through the efforts of the whole society. Strengthen scientific popularization and education on prevention and treatment, enhance public awareness of early screening and diagnosis. Early symptoms of prostate cancer are hidden, and most prostate cancer patients in China are diagnosed in the late stage. The survival time of prostate cancer patients is closely related to their malignant tumor staging during clinical diagnosis. The initial diagnosis of prostate cancer in China is mostly in the middle and late stages of clinical practice, with only 30% of clinically limited cases, resulting in a poor overall prognosis for prostate cancer patients in China. Currently, prostate cancer screening mainly includes digital rectal examination and prostate specific antigen (PSA) screening. Xing Nianzheng explained, "Relatively speaking, digital rectal examination is more painful and shameful, and the public often avoids it. PSA screening only requires blood sampling for examination, which is more convenient, less painful, and has stronger patient compliance. PSA screening greatly improves the detection rate of prostate cancer and can significantly reduce the mortality rate of prostate cancer." According to clinical testing data, under normal circumstances, if the PSA value in the blood is below 4ng/ml, abnormal patients should seek medical attention in a timely manner. With the rapid development of biomedical science, multiple early detection technologies for prostate cancer have emerged one after another. For example, measuring isomers of prostate specific antigens, prostate health index, and other indicators; With the popularization and continuous upgrading of imaging technology, multi parameter magnetic resonance imaging and PET-CT labeled with PSMA (Prostate Specific Membrane Antigen) have shown good performance in the diagnosis of prostate cancer. Therefore, these technologies have been included in multiple clinical guidelines as recommended detection methods. Xing Nianzheng believes that it is imperative to promote the advancement of the prevention and treatment of prostate cancer. As early as 2008, the United States conducted prostate cancer screening based on PSA testing for men aged 75 and above; In 2012, it covered all male groups, regardless of age. With the popularization of prostate cancer screening through PSA testing, the advanced diagnosis rate and mortality rate of prostate cancer in the United States have gradually decreased, from 3% to 4% per year from 1994 to 2013 to 0.6% from 2013 to 2020. Since 2008, Japan has implemented a prostate cancer screening strategy, reducing the incidence of metastatic diseases from 21.3% in 2000 to 11.6% in 2014. The average 5-year survival rate of prostate cancer has increased by about 11.7% annually. In Xing Nianzheng's view, the successful experience of other cancer screenings should be applied to prostate cancer screening, and PSA screening should be included in the physical examination of high-risk groups for prostate cancer. Examination should be conducted every two years, which can significantly improve the survival rate of prostate cancer patients. Although China has established clear screening standards for prostate cancer, they have not yet been popularized. Expanding the scope of early screening and diagnosis of prostate cancer, enhancing public awareness of the disease, can further improve the overall survival rate of prostate cancer patients in China. Improving the medical diagnosis and treatment system for prostate cancer and enhancing the level of standardized diagnosis and treatment. Due to China's vast territory and uneven distribution of medical resources, there are differences in the understanding and treatment of tumors between doctors and patients in urban and rural areas. Therefore, promoting the homogenization, standardization, and standardization of prostate cancer treatment is particularly crucial. In 2021, the National Health Commission released the Work Plan for Improving the Comprehensive Capacity of County Hospitals under the "Thousand County Project" (2021-2025), which stated that efforts should be made over the next five years to achieve the level of medical service capabilities of at least 1000 county hospitals in China. This also means that community hospitals have become an important part of prostate cancer diagnosis and treatment, and it is urgent to improve the standardized diagnosis and treatment level of grassroots medical institutions. In Xing Nianzheng's vision, Grade A hospitals can serve as primary system construction, while community hospitals can serve as secondary systems to promote the functional role of graded diagnosis and treatment models in the construction of prostate cancer diagnosis and treatment systems. Through a secondary system, achieve the goal of early screening for high-risk populations in the community; Through a primary system, further clarify the diagnosis and carry out corresponding early intervention for the population suspected of prostate cancer after initial screening, in order to achieve the goal of reducing the mortality rate of prostate cancer. By building an integrated center for prostate cancer diagnosis and treatment, starting from popularizing prostate specific antigen (PSA) screening, we have completed various stages such as puncture biopsy, pathology, treatment, and follow-up, bridging the closed loop of patients in the process of prostate cancer treatment. While standardizing the prostate cancer diagnosis and treatment process, we have achieved a one-stop full disease management model for patients. Xing Nianzheng introduced, "The National Cancer Center provides homogeneous diagnosis and treatment training for more than ten types of tumors, including prostate cancer. We have established an expert team to share the progress of diagnosis, treatment, and modern diagnosis and treatment plans through training, making the treatment level of prostate cancer in China more standardized and homogeneous." (Xinhua News Agency)

Edit:Xiong Dafei    Responsible editor:Li Xiang

Source:XinHuaNet

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