Benefícios e riscos do rastreamento do câncer de próstata com PSA: evidências publicadas entre 2020 e 2025
DOI:
https://doi.org/10.47224/revistamaster.v11i21.866Keywords:
Prostatic Neoplasms, Prostate-Specific Antigen, ScreeningAbstract
Prostate cancer screening remains a topic of debate due to the delicate balance between benefits and risks. This study aimed to critically synthesize the evidence published between 2020 and 2025 on the effects of PSA‑based screening, comparing traditional strategies with contemporary approaches aimed at mitigating harms. An integrative review was conducted using summaries from recent clinical trials, population‑based studies, modeling analyses, and observational research. The results show that PSA alone offers a modest yet consistent reduction in mortality and metastases when applied in an organized manner and with long‑term follow‑up, while modern strategies—such as the use of mpMRI, advanced biomarkers, and risk‑based screening intervals—substantially reduce overdiagnosis and unnecessary biopsies, maintaining or increasing the detection of clinically significant tumors. It was also found that higher‑risk groups, such as Black men, experience even more pronounced benefits from regular screening. It is concluded that the evolution of evidence supports the adoption of stratified and integrated screening algorithms that preserve the benefits of PSA while minimizing its harms, forming a more efficient, safer, and contemporary model.
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