Estimated impact of the prostate cancer prevention trial on population mortality
Estimated impact of the prostate cancer prevention trial on population mortality
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DOI：
10.1002/cncr.20919
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发表时间：
2005-04-01
期刊：
影响因子：
6.2
通讯作者：
Coltman, CA
中科院分区：
文献类型：
--
作者：
Unger, JM;Thompson, IM;Coltman, CA
背景最近完成的前列腺癌预防试验（PCPT）的潜在公共卫生影响正在辩论。结果表明，前列腺癌的周期患病率因芬普胺而降低了24.8%，而在被诊断患有癌症的男性中，也发现了高级别肿瘤（Gleason评分8-10）的比率增加（PCPT安慰剂组为5.0%，PCPT芬普胺组为11.9%）。增加的Gleason评分是否有效或是否为组织学伪影正在调查中。作者估计了在美国年龄≥ 55岁的男性中，假设5年内前列腺癌发病率降低24.8%，则可节省的人年数。还考虑了具有高等级Gleason评分的患者的不同比例的情景。随着新诊断前列腺癌的男性人数减少24.8%，作者估计，在美国，由于finaldade，将节省316，760人年。在美国癌症人群中，男性高级别肿瘤患者的比例绝对增加6.9%（相当于PCPT安慰剂组和非安慰剂组之间的比率差异），将使挽救的人年数减少到262，567。高级别肿瘤患者的比例每绝对增加5%，节省的人年数将减少约39，000。PCPT的结果如果应用于临床，可能会对前列腺癌的人口死亡率产生重大影响。Gleason评分高的前列腺癌患者比例增加的潜在不利影响将被发病率的降低所抵消。(c)2005年美国癌症协会。
BACKGROUND. The potential public health impact of the recently completed Prostate Cancer Prevention Trial (PCPT) is debated. The results indicated that the period prevalence of prostate cancer was reduced by 24.8% due to finasteride, whereas an increase in the rate of high-grade tumors (Gleason score 8-10) among men who were diagnosed with cancer also was found (5.0% in the PCPT placebo arm vs. 11.9% in the PCPT finasteride arm). Whether the increased Gleason score was valid or was a histologic artifact is under investigation.METHODS. The authors estimated the number of person-years saved assuming a 24.8% reduction in the incidence of prostate cancer for 5 years among United States males age >= 55 years. Scenarios for different proportions of patients with high-grade Gleason scores also were considered.RESULTS. With a 24.8% reduction in the number of men with newly diagnosed prostate cancer, the authors estimated that 316,760 person-years would be saved due to finasteride in the United States. An absolute increase of 6.9% in the proportion of men with high-grade tumors in the United States cancer population (corresponding to the difference between the rates on the placebo and finasteride arms of the PCPT) would reduce the number of person-years saved to 262,567. For each absolute increase of 5% in the proportion of patients with high-grade tumors, the number of person-years saved would be reduced by approximately 39,000.CONCLUSIONS. The results of the PCPT may have a major impact on population mortality from prostate cancer if they are applied clinically. The potential detrimental effects of an increased rate of patients who have prostate cancer with high-grade Gleason scores would be outweighed by a reduction in incidence. (c) 2005 American Cancer Society.