護理師正在為一位 45 歲男性提供健康篩檢諮詢。哪項測試建議用於早期發現攝護腺癌（取決於個人風險及與醫師的討論）？
A nurse is counseling a 45-year-old male client about health screenings. Which test is recommended for the early detection of prostate cancer, depending on individual risk and discussion with a provider?
- AAlpha-fetoprotein (AFP)甲型胎兒蛋白 (AFP)
- BHuman chorionic gonadotropin (hCG)人類絨毛膜促性腺激素 (hCG)
- CCarcinoembryonic antigen (CEA)癌胚抗原 (CEA)
- DProstate-specific antigen (PSA)✓ 正解攝護腺特異性抗原 (PSA)
攝護腺癌（Prostate cancer）是男性常見的惡性腫瘤之一，早期發現對於治療效果至關重要。然而，攝護腺癌的篩檢存在爭議，因為並非所有被診斷出的攝護腺癌都會對個體健康造成威脅，且篩檢可能導致過度診斷和過度治療。因此，美國癌症協會（American Cancer Society, ACS）及其他醫療組織建議，對於符合特定年齡或有高風險因子的男性，應與其醫療提供者充分討論篩檢的潛在益處和風險，做出知情的共同決策。篩檢工具主要包括攝護腺特異性抗原（Prostate-specific antigen, PSA）血液檢查和肛門指診（Digital Rectal Exam, DRE）。
Prostate cancer is one of the most common malignancies in men, and early detection is critical for treatment outcomes. However, prostate cancer screening is controversial, because not every diagnosed prostate cancer poses a threat to individual health, and screening can lead to overdiagnosis and overtreatment. Therefore, the American Cancer Society (ACS) and other medical organizations recommend that men of an appropriate age or with high-risk factors fully discuss the potential benefits and risks of screening with their healthcare provider and arrive at an informed, shared decision. The main screening tools are the prostate-specific antigen (PSA) blood test and the digital rectal examination (DRE).
攝護腺癌篩檢的建議在美國和台灣均強調醫病共同決策。美國的指引，如美國泌尿科協會（AUA）和美國癌症協會（ACS），建議一般男性從 50 歲開始與醫師討論篩檢，高風險族群（如非洲裔美國人或有家族史者）可提前至 40-45 歲。台灣衛生福利部國民健康署目前未將攝護腺癌納入常規癌症篩檢項目，但醫學會建議，男性可從 50 歲開始考慮 PSA 篩檢。兩地都強調 PSA 篩檢並非完美，可能導致過度診斷，因此需謹慎評估。