Lukas Owens, Ojas Brahme, Roman Gulati, Ruth Etzioni
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引用次数: 0
摘要
最近的研究表明,美国新发转移性前列腺癌的发病率在 2010 年至 2019 年期间有所上升。合理的解释包括:建议不要进行前列腺癌筛查后,发现时间推迟;或使用更敏感的成像技术后,发现时间提前。利用监测、流行病学和最终结果病例并控制人口老龄化,我们发现在此期间,前列腺癌诊断时的中位年龄和前列腺特异性抗原(PSA)水平分别增加了 1.4 岁(95% CI 1.3-1.5)和 1.4 纳克/毫升(95% CI 1.4-1.5),与延迟检测假说一致。在这一时期,非西班牙裔黑人男性诊断时 PSA 的第 75 百分位数增加了 4.3 纳克/毫升(95% CI 3.7-4.8),而非西班牙裔白人男性则为 3.0 纳克/毫升(95% CI 2.8-3.2)。总体而言,诊断时的患者特征表明,延迟检测至少在一定程度上导致了新发转移性疾病的增加。
Trends in Age and Prostate-Specific Antigen at Prostate Cancer Diagnosis between 2010 and 2019.
Recent studies have shown that de novo metastatic prostate cancer incidence in the U.S. increased from 2010 to 2019. Plausible explanations include delayed detection following recommendations against prostate cancer screening or upstaging associated with use of more sensitive imaging technologies. Using Surveillance, Epidemiology and End Results cases and controlling for aging of the population, we found the median age and prostate-specific antigen (PSA) level at prostate cancer diagnosis increased by 1.4 years of age (95% CI 1.3-1.5) and 1.4 ng/mL (95% CI 1.4-1.5) over this period, consistent with the delayed detection hypothesis. Racial differences were noted, with 75th percentiles of PSA at diagnosis increasing by 4.3 ng/mL (95% CI 3.7-4.8) over this time period for non-Hispanic Black men compared to 3.0 ng/mL (95% CI 2.8-3.2) for non-Hispanic White men. Overall, patient characteristics at diagnosis suggest that delayed detection contributed at least in part to increases in de novo metastatic disease.