Epidemiology of prostate cancer in the Umbria region of Italy: Evidence of opportunistic screening effects
Epidemiology of prostate cancer in the Umbria region of Italy: Evidence of opportunistic screening effects
复制标题
DOI：
10.1016/j.urology.2003.07.007
复制
发表时间：
2003-12-01
期刊：
影响因子：
2.1
通讯作者：
Mastrandrea, V
中科院分区：
文献类型：
--
作者：
la Rosa, F;Stracci, F;Mastrandrea, V
目标.研究1978年至1999年意大利翁布里亚地区前列腺特异性抗原筛查对前列腺癌发病率、死亡率和生存率的影响。发病率分别来自1978年至1982年和1994年至1999年期间的特别调查和癌症登记记录。使用官方出版物的数据，通过联合点分析评估死亡率趋势。同时计算观察到的、相对的和年龄校正的相对存活率。1997年至1999年的新诊断病例数几乎是1978年至1982年的4倍，粗发病率是3倍多，年龄调整后的发病率增加了约125%。死亡率无明显趋势。存活率也有很大提高。1978年至1982年和1994年至1998年发病病例的5年相对生存率分别为37%和74%。75岁以上人群的发病率和生存率与年轻人群一样显著增加。与许多其他发达国家一样，前列腺癌筛查活动可能是研究地区观察到的发病率和存活率增加的原因，但死亡率下降的趋势尚不明显。可能在所有年龄组，包括老年人中进行免疫学筛查，尽管老年人不太可能从干预中受益。机会性筛查的评价是困难的，缺乏评价意味着无效干预和护理不平等的高风险。(C)2003年爱思唯尔公司
Objectives. To examine the impact of prostate-specific antigen-based screening on prostate cancer incidence, mortality, and survival in the Umbria region of Italy for the period 1978 to 1999.Methods. Incidence rates were derived from an ad hoc survey and from cancer registry records for the period 1978 to 1982 and 1994 to 1999, respectively. The mortality trend was assessed by joinpoint analysis using data from the official publications. The observed, relative, and age-adjusted relative survival rates were also calculated.Results. The number of newly diagnosed cases in 1997 to 1999 was almost four times greater than in 1978 to 1982, the crude incidence rate was more than three times, and the age-adjusted incidence rate increased by about 125%. No trend was apparent for mortality. The survival rates also showed a large increase. The 5-year relative survival rate was 37% and 74% for 1978 to 1982 and 1994 to 1998 incident cases, respectively. People older than 75 years showed the same striking increase in incidence and survival rates as the younger age groups.Conclusions. As in many other developed countries, prostate cancer screening activities are the likely cause of the increase in incidence and survival rates observed in the study area, but a decreasing mortality trend is not yet evident. Opportunistic screening is likely to be performed among all age groups, including the elderly, although the latter are unlikely to benefit from intervention. The evaluation of opportunistic screening is difficult and a lack of evaluation implies a high risk of ineffective interventions and inequality of care. (C) 2003 Elsevier Inc.