Tyrol Prostate Cancer Demonstration Project: Early detection, treatment, outcome, incidence and mortality
Tyrol Prostate Cancer Demonstration Project: Early detection, treatment, outcome, incidence and mortality
复制标题
DOI：
10.1111/j.1464-410x.2008.07502.x
复制
发表时间：
2008-04-01
影响因子：
4.5
通讯作者：
Boyle, Peter
中科院分区：
文献类型：
--
作者：
Bartsch, Georg;Horninger, Wolfgang;Boyle, Peter
目的：评价在奥地利蒂罗尔州人群中实施一项控制良好的前列腺癌早期检测和治疗计划的有效性，1988年开始实施早期检测和治疗方案，并向所有45岁的男性免费提供前列腺特异性抗原（PSA）检测，75年从1993年。对象和方法比较前列腺癌死亡率在蒂罗尔州和奥地利其他地区是通过广义加法模型完成的。分段线性变点泊松回归模型被用来比较蒂罗尔州和奥地利其他地区的死亡率。参照1986- 1990年的死亡率计算标准化死亡率。1993年以来，86.6%的合格男性至少接受过一次检测。2005年蒂罗尔州的癌症死亡率比预期低54%（95%置信区间[CI] 34-69%），而奥地利其他地区为29%（95% CI 22-35%）。蒂罗尔州前列腺癌死亡率的下降趋势明显大于奥地利其他地区（P = 0.001）。一个显着的迁移到较低阶段的疾病发生和根治性前列腺切除术与低morbidity.CONCLUSIONSIn蒂罗尔地区的治疗是免费提供给所有患者，广泛的PSA检测和治疗与治愈的意图发生，有前列腺癌死亡率的减少，这是显着大于在奥地利其他地区的减少。前列腺癌死亡率的降低很可能是由于早期发现，随后的分期下调和有效治疗前列腺癌。
OBJECTIVETo evaluate the effectiveness of a well-controlled programme of early detection and treatment of prostate cancer in the population of Tyrol, Austria, where such a programme of early detection and treatment was initiated in 1988 and where prostate-specific antigen (PSA) testing was offered for free to all men aged 45-75 years from 1993.SUBJECTS AND METHODSComparison of prostate cancer mortality rates in Tyrol and the rest of Austria was accomplished through a generalized additive model. A piecewise linear change-point Poisson regression model was used to compare mortality rates in Tyrol and the rest of Austria. Standardized mortality ratios were calculated with reference to the mortality rates in 1986-1990.RESULTSIn all, 86.6% of eligible men have been tested at least once since 1993. Cancer deaths in Tyrol in 2005 were 54% (95% confidence interval [CI] 34-69%) lower than expected compared with 29% (95% CI 22-35%) in the rest of Austria. The decreasing trend in prostate cancer mortality was significantly greater in Tyrol compared with the rest of Austria (P = 0.001). A significant migration to lower stage disease occurred and radical prostatectomy was associated with low morbidity.CONCLUSIONSIn the Tyrol region where treatment is freely available to all patients, where widespread PSA testing and treatment with curative intent occurs, there was a reduction in prostate cancer mortality rates which was significantly greater than the reduction in the rest of Austria. This reduction in prostate cancer mortality is most probably due to early detection, consequent down-staging and effective treatment of prostate cancer.