627 155612226014562114 Ces38227936014570127174 Urol40217936014578115180208 2018;42547936014562121176230253 22(1):45337936014561121152206230252 14–2648117936014561115178233291 PŘEHLEDOVÝ3675207016974156235334409485586692777867 ČLÁNEK4580207016989163260360438521 studií62489801314176133193215236 nebyla884898013167120180227251299 provedena1207898013169101158206258318371429478 metodologicky1717898013190143176232292351374432492514562607659 správně2400898013149108140190238297350 a6241048013150 že6981048013150101 teprve823104801314091151183236287 při1140104801316193115 délce12851048013160112135183234 sledování1543104801314769122182240288338396418 10–1519851048013159106164210255 let2264104801312982115 dochází24091048013160118167225274318341 u6241198013158 screenovaných703119801314089120172225283341389439496542589647 pacientů13701198013161110159180233290322379 k17701198013146 významnému18361198013150102148207255344401454543600 snížení2456119801314198120163215272294 mortality6241348013192153186225276299322357410 na10591348013169120 karcinom12041348013156109141190213272332425 prostaty,16541348013171104163204240292325378392 srovnatelnému2072134801315082141191252303336389413472527619678 s6241498013142 ostatními6921498013169111147199232293316408431 onemocněními,11491498013169130185277338390450505565588681704723 pro18971498013171105164 které2086149801315796149182236 je2347149801313388 běžně24601498013171128174235290 populační6241648013161120180238260309357415437 screening1085164801314190121173226284306364423 prováděn.1532164801316193149198247307360417436 Ve7741798013156105 shodě903179801314098156216269 s11961798013140 publikovanými12591798013161119179202223269325374423481527618639 daty19211798013160109141192 není21371798013159112169191 v23511798013150 součas‑2425179801314098156205254294325 né6241948013159112 době7601948013168126187241 ve10251948013158109 většině11591948013157109142184205263316 zemí14991948013152104193215 otázkou,1738194801316699148193239296354372 zda21351948013152110159 screening2318194801314998129181235293315372432 karcinomu624209801314797129175197255313403460 prostaty1105209801316193149189224273305357 provádět,1483209801316193149197247307359392411 ale1915209801315073125 jak2065209801312069114 ho22002098013159117 provádět.2339209801316092149197247306359392411 Screening,624224801315199130181234291312369428446 resp.1093224801312980119178195 program1308224801316092148207238287375 časného1703224801314998137194246304361 záchytu,2084224801314494142199245281339356 by24602248013160107 měl25872248013189141163 v6242398013151 současné7012398013150111171221273314374429 probíhat11562398013171104163226249312363396 selektivně15782398013150106130185232271294345407462 na20652398013169120 základě22102398013155107155180231293348 do‑25832398013170130167 poručení6242548013161121153212261313371393 odborných10422548013167128188248280340386434492 společností15592548013149109169192246296354413454489511 s20942548013150 přihlédnutím21682548013170102125183205259320378436470492582 k6242698013146 epidemiologické,6882698013153111132190241328348405427483541562609653703719 zdravotnicko‑organizační1425269801314410013017922528031136838943547953456862765871476181783888092997610321053 a24972698013149 eko‑2565269801315296151185 nomické6242848013158115203224271316366 situaci100928480131416194150198245266 v12942848013150 dané13632848013159106163215 zemi1597284801314494181203 a18192848013149 individuálnímu1891284801311975133154203225282338386407463484572627 zdra‑25382848013143100131179212 votnímu6242998013150107139197219308365 stavu1013299801314176125173231 a12682998013150 přání1342299801316193143200222 informovaného1588299801312381108165197287346394444502555613671 pacienta.22832998013161111159181234292323373392 Hlavní774314801317195146195257280 téze1079314801314497144198 onkologické13023148013169130177237261321384407458505559 prevence18873148013171104158209263323374427 nedávno23403148013169124187238288349410 jasně624329801312370109165216 definovala8593298013159110135161217274321369391438 Česká13163298013162111150194243 onkologická15783298013158115159214236293352373420464513 společnost2110329801314098156178229277333390429462 ČLS25913298013162108159 JEP624344801313888142 a7863448013150 Ministerstvo8563448013186108166187226261312343384418471528 zdravotnictví14043448013144102134183231288320378400448484537559 ČR.19843448013163116137 Česká21423448013162113154198249 republi‑2415344801312981140198258281302335 ka624359801314797 splňuje7453598013143103126183240262315 všechny1084359801315192144194252309355 uvedené14653598013159108160220273331384 odborné18753598013159119179238270329382 požadavky22833598013161120162213272321369415467 na6243748013159108 provádění761374801316193149198247307360417439 selektivního1224374801314699122175220257279329388409469528 screeningu1776374801314695126178231289311368428485 karcinomu22853748013152103134181202260318408465 prostaty,624389801316295152194229280313365379 a10283898013159 to11123898013143100 zejména12373898013153106129219274333383 pro16453898013170103161 určitou18313898013168100147170204261321 definovanou21763898013170124150177236296345396455515574 věkovou6244048013150101147204252309367 skupinu1015404801314085143203225283340 mužů13784048013191148192249 a16514048013150 pro1724404801316193150 muže18974048013190147191243 s21644048013140 předchozím2227404801316193144205253311369411434523 výskytem6244198013149100140184235272322410 nádorového10534198013159107165222254309357408465522 onemocnění.15954198013158116168256313362419471528549566 Na21814198013170118 provádění2318419801316092147195244302354411432 screeningu624434801314293125179234294317377438497 těchto1147434801314396147206240297 populací14704348013170132194254277328378401 nyní18964348013169117178201 panuje21224348013171123183242265319 shoda24674348013150110170232283 mezi6244498013190143188210 odbornými8634498013159119178238270328374465486 společnostmi13744498013145104163187239289346405445479569590 (Česká1988449801313492144184229280 urologická2296449801315990146169227288310358403454 společnost6244648013141100160183236285343401441476 a11244648013158 Česká12064648013171122163208259 onkologická14894648013166125170227250309369391439485536 společnosti20494648013149108167190243293351409449484506 ČLS25794648013171118171 JEP),624479801313888141166182 Ústavem8264798013168106140190237288377 zdravotnických12234798013144101132182229286318376397445490541588645 informací1892479801311976104161192282330378400 a23124798013150 statistiky2382479801314075124156177216250272317368 ČR6244948013163117 a7654948013153 Ministerstvem8464948013186108166187226261312343384419471523612 zdravotnictví14824948013148106137187235292324383404453489541564 ČR20744948013162116 a22144948013154 dominant‑22964948013160118207229287336393425454 ními624509801315981169191 plátci839509801316184133165211233 péče10965098013161115164215 v13355098013149 České14095098013162113154199250 republice.1683509801313384144202262285306354405422 KLÍČOVÁ6255384014770132164236320392464 SLOVA11165384014762123207279351 Screening,6245548013151100131183237295316374433451 časný1100554801314998138195241 záchyt,1365554801314595144202248285304 karcinom,1693554801314798129176197255313403421 prostata.2138554801316193149189224273305355374 SUMMARY6255834014762143243345423493561 Zachoval7745998013160110159217276324375397 R,1195599801316485 Dušek13125998013172131170223269 L,1606599801315777 Babjuk17085998013163114174197254300 M.20405998013186107 Problematika2171599801316394151212235288378427460482528579 screeningu624614801314190121173227284306364423480 karcinomu1128614801314798129176197255313403460 prostaty.1612614801316193149189224273306357370 Major7746293013591146174234272 statement:1068629301355290145182237329385447483508 Screening1604629801315199129180232289310366425 is2052629801313068 an21436298013156113 attempt2279629801315788123173261320352 to2654629801314095 identify624644801312381132189219240267318 individuals965644801311874132153201223280336383404442 with14256448013179100132189 a16326448013150 certain1700644801314998128164212233289 disease2007644801316080118170217255307 in2337644801311874 a24296448013150 broad2497644801316091146195253 segment624659801314193151239291347377 of1019659801315986 the1128659801312985137 population12836598013160118177234254302332353410467 –17686598013154 those1845659801312986143181233 for2101659801312479110 whom22296598013179136193281 there2533659801312986137167217 is624674801312361 no7096748013166124 reason856674801314091139178235293 to1173674801314196 suspect12936748013148104143201255304339 the1656674801314198151 disease.1830674801316889127180227266319335 Now21956748013171129207 there2425674801314199151182233 is2681674801313169 clear624689801314969120166196 evidence8376898013153100121178229285331380 that1240689801312884131162 PSA14196898013155103163 screening1599689801314188117167219275295350408 reduces2029689801312777135190237286324 mortality23706898013190146176211259280300331380 if624704801312350 carried6977048013156105135167188240299 out10197048013166123155 for1197704801313692123 10–1513437048013161107164209253 years.16197048013156107154184224243 The18857048013158117169 Czech20847048013163108159207264 Republic23717048013163115173231289311332379 meets6247198013189139190221261 all90171980131496989 requirements1012719801312776133188207236285371422477507546 to1575719801313386 perform16787198013160111140170225254341 selective2036719801314091111161208242262309358 prostate2411719801316089143181213260290339 screening,624734801314086115164215270289344400417 particularly10577348013160107136170190236290310356385405451 for1530734801312277106 a16537348013149 certain1718734801314896125160207226281 age20157348013149106156 group2187734801315988142197253 of2457734801315783 men25577348013188138193 and6247498013150107165 for812749801312581112 men9437498013190142199 with11617498013180101134191 a13717498013150 history1440749801315980117151206237287 of1747749801315885 other1852749801315889146198229 tumour2104749801313087174232288319 disease2442749801316080118170217256308 with6247648013179101133190 a8367648013150 life90976480131224370121 expectancy10527648013153100159212260295344400448498 of1571764801315986 10–1516797648013154100157202246 years.19467648013149100147177217235 Screening3126898013151100131183237295316374433 is358389801312362 an3669898013150108 attempt380189801315082119170259318351 to417689801313490 identify429089801312383135193225247276328 individuals464289801312381140162211234293350399421460 with29761048013179102135193 a31931048013156 certain32731048013154105136173223245302 disease3604104801316082121174222262315 in3943104801312886 a40531048013155 broad4137104801316193150199259 segment4420104801314699160249302360391 of4835104801316493 the4952104801313997150 population29761198013160119179236258306338359416474 –34701198013155 those3548119801313088145185237 for3809119801312582113 whom39421198013179137194283 there4249119801313087140171222 is4494119801311958 no45721198013158116 reason4712119801312879127166223281 to5017119801313085 suspect2976134801314197137196250299335 the3336134801313088141 disease.3497134801316082121174222262315332 The38501348013151111164 screening4034134801314190121173226284306364423 is4481134801311958 performed45601348013160114146178235267357410470 if5054134801312048 there2976149801313491144175226 is3225149801311958 a33031498013149 high3372149801315980139196 risk359114980131295189134 of3745149801315886 a38511498013149 disease3920149801316081120172220259312 within42511498013179102134192213270 a45411498013150 population,46101498013161119179237258306338360417475492 if2976164801312351 a30511648013154 proper3133164801316193149209263295 diagnostic3456164801316081130189247305345380402450 method39341648013190143176234292353 exists,43111648013157105127166201242261 and45961648013154111171 if4791164801312755 there4870164801313896149180232 is2976179801312364 the30651798013143102157 possibility32471798013170131172213235296319342364399451 to37231798013143101 treat3849179801314376129178211 the40851798013143103157 disease4267179801317092133187236277332 effectively.4624179801316392123176227264287338391415464478 The29761948013151111164 term3164194801314091123212 “early3401194801313887135166189237 detection”36621948013166119152203252288310368427457 is4143194801312968 mainly42411948013190139160218240288 used45531948013165104157217 for4794194801313592124 op‑49421948013165125160 portunistic29762098013161120152189247304326365400422470 or3470209801315991 selective3585209801314194116169219255277326378 screening.3987209801314190121173227285306364423442 The31262248013151110162 primary3308224801316091113201249280331 objective36582248013158118140192240276297346397 of4074224801315886 screening4180224801314189119170223280301358417 is4620224801311957 to4701224801313085 reduce4809224801312979139195243293 mortality29762398013190148180217267289311344395 while33932398013179138159181234 keeping3648239801314799152212235292352 the4024239801313189142 same4190239801313889177231 quality44422398013160117166188209243294 of4757239801315987 life486823980131214271123 as5012239801315090 if2976254801312351 no30462548013159117 disease3182254801316081120172219259311 was35132548013179128167 diagnosed.3700254801315980128187244301341393453471 Secondary41912548013151103152207265324372403454 objectives46652548013158117139191240276298346397437 are2976269801315081133 related3133269801313890112161193244304 to3461269801314096 identifying3581269801312988141199230252281333356414473 more40842698013190148180232 individuals4340269801312986146168217240299356405427466 in4830269801312886 less4940269801312982122162 advanced29762848013150109159209266315366426 stages3426284801314175125184237277 of3727284801315887 the3838284801313391145 disease4006284801316082121174222262315 and43442848013150108167 mapping45352848013190139198259281339398 the4957284801313492145 incidence2976299801312381129151210263321369420 of3425299801315987 the3536299801314098151 disease3716299801316081120173222261314 precisely4060299801316092144193215254307330378 in4462299801312885 a45712998013155 respective4650299801313890130189243292329351400452 region.2976314801313284144166224282301 The31263298013152112166 implementation33163298013132121182205259348402461493543576598657716 of4057329801316796 Prostate4177329801316495152193228278310362 Specific45633298013160120174225247273300349 An‑49363298013173132166 tigen2976344801313456116169227 examination32273448013162110160249271329378410432490549 played3801344801316992141187240300 a41253448013159 key42083448013155107154 role4387344801314097120174 for4585344801313794126 prostate47363448013169101158198233283315366 screening.2976359801314190121173227284306364423442 In3442359801312684 several3550359801314497146197229279301 countries,38753598013152108166224256287310362403421 a43203598013153 large4397359801312775107164217 increase4638359801312684133164215264303356 in5018359801312684 incidence2976374801312378125146203254310357407 was34013748013178126164 seen,3584374801314092144200217 as3819374801314988 was39253748013178126164 a41083748013149 decrease41763748013158109157187237284322373 in4572374801311874 metastatic46653748013188140171219257291339369390437 stage2976389801314176125185238 identification.3238389801313190143201233255281308356406439461518577596 Nevertheless,38663898013170124173225256293351404427480520560579 screening4469389801314998129181235293315372432 was49333898013179129169 still297640480131417698120141 controversial,31414048013150106165196228285333385416457478527549566 mainly37324048013190139161218241289 for4045404801312986118 the4188404801313492145 uncertain43584048013159116165216247284334356413 impact47954048013124113172222271307 on29764198013159117 mortality31204198013190148180217267289310344395 reduction3539419801313587147204253289311369427 and39904198013153110170 for4184419801313188120 the4329419801313694147 diagnosis4503419801316081130189247305345366405 and49324198013153111170 treatment2976434801313466117165197287340398430 of3430434801316594 clinically354843480131567899157178227276299320368 non39404348013166125183 significant4147434801314869128186208234260309359416448 stages4619434801314883132192245285 and49284348013157115174 related2976449801313283106154186237297 adverse32934498013149109158209240281334 screening3647449801314189120171225282304361420 side-effects.4087449801314162121173208263291321372422458499518 However,46254498013169127205257305357388401 it5050449801311952 was29764648013178127166 recently3165464801312878127177233264286333 clearly3517464801314970122169199221268 demonstrated38044648013159111199256313352385416465496546605 that4433464801312986134165 most46174648013189146185219 of4855464801315886 the4964464801312986138 studies2976479801314175131190211263303 were32984798013179130161212 not35294798013159116148 performed36974798013160113144175231263352404463 properly.4180479801316092147207260291313360373 Now45734798013169127204 there4801479801312987139170220 is5045479801311957 clear2976494801314971124171203 evidence31994948013153102124183236294342393 that3616494801313088137169 screening3805494801314190121172226284305362422 reduces4251494801312880140197245296336 mortality46074948013190148180217266289310343394 in5025494801311977 case2976509801314999139192 of3193509801315987 10–1533065098013154101159205250 years35805098013150102150181222 of3828509801315987 duration39415098013160117148198230252310368 and43335098013152110169 this4526509801313694116155 mortality47075098013190148180217267289310344395 reduction2976524801313282141196244279300356413 is3412524801311956 the3491524801313086138 same3648524801314089176228 as3895524801314987 in4005524801311975 other4099524801315789145197227 diseases4345524801315980118169216255306345 for4713524801312580111 which48435248013178135156203259 screening2976539801314190121173227284306364423 is3423539801312362 performed.35095398013161115146178236268357411471490 In3126554801312483 accordance32355548013159109158215249308359418469521 with37905548013181105140200 the40155548013143103158 published41985548013171131192216239279339393456 literature,467955480131325590142175227260320352405423 it2976569801312357 is3058569801313272 not31545698013168128161 a33395698013159 question34235698013169127181222257280339398 if3846569801313261 prostate39315698013170103161201237287320372 screening43285698013150100132184239298320379439 should47925698013150109168227250310 be29765848013161115 performed,31155848013168122153185242274364417478496 but36355848013167126159 how38185848013166124203 it4045584801313063 should41325848013148106164222244303 be44595848013168122 performed.46055848013168122153185243275364418478497 Screening,29765998013151100131183236294316373433451 or3447599801315991 the3562599801313088141 early37245998013153101132155203 detection39485998013159112145196246282304362420 program,4389599801316092149209240290379397 should4806599801314199157215237296 be29766148013162118 performed31196148013170125158191250283375430492 selectively36366148013150105128183234271294345398422471 based41326148013170122163217279 on44366148013168129 the45906148013143102157 recom‑4772614801314295146203295330 mendation29766298013190143201261309341364421480 of3482629801315886 expert35946298013154101161215247284 organizations3904629801315890148197254276320371403425483541581 regarding4509629801313485146194226283305363422 the4955629801313694147 epidemiological,29766448013153113135195247336358416439497557579627677699717 health,37196448013159112160182215273291 structural4034644801314378110168216253310342392414 and44726448013152109169 economic46676448013153103159217275365387435 situation297665980131426398156206239262320380 of3381659801316796 a35026598013159 respective3585659801314294135195250301338360411463 country,40736598013158115174233265298351364 and44626598013159118178 regarding4665659801314193155204236295318376437 the2976674801313492145 individual3145674801313088147169218241300357406428 health35976748013166119167189222280 condition39026748013155111170229251284307364423 and43496748013157114174 wishes45546748013179102141198251291 of4869674801316694 an49876748013157115 informed2976689801312381108165197287341401 patient.34016898013161111143165217275307326 Recently,31267048013156110160211270302325373386 the35377048013142101154 main37247048013191140162221 thesis39697048013142101155195217256 of4250704801316796 oncological43707048013167126176232255314375397446496519 pre‑49137048013170102154189 vention29767198013151104163196219279339 was33487198013181132173 defined35467198013169124150178237291353 by39247198013170119 the40687198013143103157 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