THE ETIOLOGY OF PROSTATE-CANCER - WHAT DOES THE EPIDEMIOLOGY SUGGEST
THE ETIOLOGY OF PROSTATE-CANCER - WHAT DOES THE EPIDEMIOLOGY SUGGEST
复制标题
DOI：
10.1002/pros.2990040403
复制
发表时间：
1983-01-01
期刊：
影响因子：
2.8
通讯作者：
HENDERSON, BE
中科院分区：
文献类型：
--
作者：
ROSS, RK;PAGANINIHILL, A;HENDERSON, BE
在洛杉矶[美国加利福尼亚州]，前列腺癌的两个最重要的人口统计学特征是黑人的高发病率，是白人的2倍，是亚洲人的4倍；随着年龄的增长，发病率在40岁以后迅速上升。尽管黑人的死亡率很高，但一项出生队列分析表明，1900年以后出生的黑人男性的死亡率有所下降。本文回顾了支持3种病原学假设（工业接触镉、传染源的性传播和内分泌因素）的流行病学和实验证据。来自洛杉矶描述性数据的证据表明，只有一小部分病例可能归因于工业暴露。在一项对天主教神父的队列研究中，没有发现前列腺癌死亡率的赤字，并且有强有力的证据表明这种疾病不会通过性传播。实验证据和有限的人体数据支持内分泌假说。一项前列腺癌病例对照研究的初步结果被提出，但这些结果无法进一步区分这些假设。研究发现，输精管切除术具有实质性的保护作用，并伴有前列腺功能和大小的降低，但这一结果迄今为止在统计学上并不显著。
The 2 most important demographic characteristics of prostate cancer in Los Angeles [California, USA] are the high rates among blacks, which are 2 times those among whites and 4 times those among Asians, and the rapid increase in rates with age after age 40. Despite the high rates among blacks, a birth cohort analysis indicates that mortality rates among black men born after 1900 have decreased. Epidemiologic and experimental evidence supporting each of 3 etiologic hypotheses (industrial exposure to Cd, sexual transmission by an infectious agent and endocrine factors) are reviewed. Evidence from descriptive data in Los Angeles suggests that only a small portion of cases might be attributable to industrial exposures. In a cohort study of Catholic priests, no deficit of prostate cancer mortality was found, and strong evidence against sexual transmission of the disease. Experimental evidence and a limited amount of human data support an endocrine hypothesis. Preliminary results of a case-control study of prostate cancer are presented, but these results are unable to distinguish among these hypotheses further. A substantial protective effect of vasectomy, an event that is accompanied by reduced prostatic function and size, was found but this result is thus far statistically insignificant.