— 健康促進與維護 · HARD · MCQ —
一位 50 歲男性對攝護腺癌篩檢感到擔憂。依據現行指引，護理師最合適的建議為何？
A 50-year-old male is concerned about prostate cancer screening. What is the most current nursing recommendation based on guidelines?
- AMandate a PSA test every year starting at age 50規定自 50 歲起每年進行 PSA 檢測
- BDiscuss the risks and benefits of PSA testing with the provider✓ 正解與醫療提供者討論 PSA 檢測的風險與益處
- CRecommend against PSA testing for all men under 60建議所有 60 歲以下男性避免進行 PSA 檢測
- DPerform a digital rectal exam regardless of PSA results無論 PSA 結果如何，均進行數位肛門指診
— Explanation · 中文詳解 —
攝護腺特異抗原（PSA）篩檢存在過度診斷與過度治療爭議。美國預防服務工作小組（USPSTF）建議，55-69 歲男性應在充分知曉篩檢利弊後，由醫病共同決策是否進行。強制篩檢（A）或全面反對（C）均不符合個體化醫學原則。
Prostate-specific antigen (PSA) screening carries controversy related to overdiagnosis and overtreatment. The U.S. Preventive Services Task Force (USPSTF) recommends that men aged 55–69 engage in shared decision-making with their provider after a full discussion of the benefits and harms of screening. Mandatory screening (A) or universal opposition (C) does not align with principles of individualized medicine.
✦ 台美臨床差異
美國醫學界對 PSA 篩檢爭議較大；台灣臨床上泌尿科醫師多鼓勵 50 歲以上男性接受篩檢，觀念較傾向早期診斷早期治療。