Prostate Cancer Screening in Men of African Descent: 15-year Results of the Tobago Prostate Cancer Survey

IF 0.2 4区医学 Q4 MEDICINE, GENERAL & INTERNAL

West Indian Medical Journal Pub Date : 2018-12-31 DOI:10.7727/wimj.2016.312

A. Patrick, Jb Nelson, J. Weissfeld, R. Dhir, R. Phillips, J. Zmuda, C. Bunker

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引用次数: 1

Abstract

Objective: To compare all-cause-mortality in screening-detected prostate cancer cases versus non-cases after a median 12.2-year follow-up. Methods: In this prospective, population-based study of 3089 Afro-Caribbean men aged 40–79 years in Tobago, Trinidad and Tobago, West Indies, all men were screened for prostate cancer (serum prostate specific antigen and/or digital rectal exam) one to three times between 1997 and 2007 and followed for mortality to 2012. Among 502 men diagnosed with prostate cancer, 81 younger men underwent radical retropubic prostatectomy. Minimal treatment was available for older men. Survival curves compared all-cause-mortality in cases versus non-cases within 10-year age groups at first screening. Results: There were 350 all-cause-deaths over 34 089 person-years of follow-up. All-cause-survival curves in men aged 60 years or above at first screening did not diverge between cases and non-cases until after 10–12 years of follow-up (p > 0.36). In contrast, among men first screened at age 50–59 years, survival was lower in cases, with survival curves diverging at seven years (p = 0.003). Survival in men aged 50–59 years who underwent prostatectomy was similar to survival in non-cases (p = 0.63). Conclusion: Among men aged 60 years or above, the absence of excess all-cause-mortality among screening-detected prostate cancer cases provides argument against the utility of routine prostate cancer screening in this older population of African descent. However, the significantly poorer survival in men aged 50–59 years with screening-detected prostate cancer, compared with screened men without prostate cancer, along with the potential for prostate cancer treatment to improve survival, supports the continuation of prostate cancer screening in this age group, pending further research to assess the risks and benefits.

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非洲裔男性前列腺癌筛查:多巴哥前列腺癌调查的15年结果

目的:在中位随访12.2年后，比较筛查发现的前列腺癌病例与非病例的全因死亡率。方法:在这项前瞻性、基于人群的研究中，来自多巴哥、特立尼达和多巴哥、西印度群岛的3089名年龄在40-79岁的非洲裔加勒比男性，所有男性在1997年至2007年期间接受了1至3次前列腺癌筛查(血清前列腺特异性抗原和/或直肠指检)，并随访死亡率至2012年。在502名诊断为前列腺癌的男性中，81名年轻男性接受了根治性耻骨后前列腺切除术。老年男性只能接受最低限度的治疗。生存曲线比较了首次筛查时10岁年龄组中病例与非病例的全因死亡率。结果:在34089人-年的随访中有350例全因死亡。首次筛查时60岁或以上男性的全因生存曲线在病例和非病例之间直到随访10-12年后才出现差异(p < 0.36)。相比之下，在50-59岁首次筛查的男性中，生存率较低，生存曲线在7岁时偏离(p = 0.003)。50-59岁男性前列腺切除术患者的生存率与未手术患者相似(p = 0.63)。结论:在60岁或以上的男性中，筛查发现的前列腺癌病例中没有过多的全因死亡率，这为反对在非洲裔老年人群中进行常规前列腺癌筛查提供了论据。然而，50-59岁前列腺癌筛查男性的生存率明显低于未筛查男性，以及前列腺癌治疗提高生存率的潜力，支持在该年龄组继续进行前列腺癌筛查，有待进一步研究评估风险和收益。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

West Indian Medical Journal 医学-医学：内科

CiteScore

0.20

自引率

0.00%

发文量

审稿时长

4-8 weeks

期刊介绍： The Journal is international in scope, with author and editorial contributions from across the globe. The focus is on clinical and epidemiological aspects of tropical and infectious diseases, new and re-emerging infections, chronic non-communicable diseases, and medical conditions prevalent in the Latin America-Caribbean region, and of significance to global health, especially in developing countries. The Journal covers all medical disciplines, as well as basic and translational research elucidating the pathophysiologic basis of diseases or focussing on new therapeutic approaches, and publishes original scientific research, reviews, case reports, brief communications, letters, commentaries and medical images. The Journal publishes four to six issues and four supplements annually. English is the language of publication but Abstracts are also duplicated in Spanish. Most of the articles are submitted at the authors’ initiative, but some are solicited by the Editor-in-Chief. Unless expressly stated, the Editorial Board does not accept responsibility for authors’ opinions. All papers on submission are reviewed by a subcommittee. Those deemed worthy for review are sent to two or three reviewers (one of the three might be a statistician if necessary). The returned papers with reviewer comments are reviewed by the Editor-in-Chief. Papers may be rejected, accepted or sent back to authors for revision. Resubmitted papers from authors are reviewed by the Editor-in-Chief and may be sent back to reviewers or a final decision made by Editor-in-Chief. The decision of the Editorial Board is final with regards to rejected articles. Rejected articles will not be returned to the authors. The editorial subcommittee has the right to return sub-standard manuscripts to the authors, rather than passing them on to the reviewers. This implies outright rejection of the manuscript.