Prostate-specific antigen screening and mortality from prostate cancer
Prostate-specific antigen screening and mortality from prostate cancer
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DOI：
10.1007/s11606-007-0479-7
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发表时间：
2008-03-01
影响因子：
5.7
通讯作者：
Wilcox, Homer
中科院分区：
文献类型：
--
作者：
Marcella, Stephen W.;Rhoads, George G.;Wilcox, Homer
背景：没有来自随机试验的可用证据表明前列腺癌的早期检测可以改善健康结果，但前列腺特异性抗原 (PSA) 测试通常用于筛查男性前列腺癌。目的：本研究的目的是了解 PSA 筛查是否会降低前列腺癌死亡率。设计、环境和参与者：这是一项病例对照研究，对种族、年龄和可接触 PSA 筛查的时间进行一对一匹配。死者 380 名，来自 1997 年至 2000 年（含）新泽西州生命统计数据，诊断时年龄为 55-79 岁，与没有转移性前列腺癌的活着的对照相匹配。从所有提供者处获得医疗记录，我们提取了从 1989 年到每个指示病例诊断时的 PSA 检测信息。测量：测量包括病例和对照之间筛查（是、否）的比较。相关性的衡量标准是比值比。 结果：从 1989 年到 1999 年，每年都会诊断出符合条件的病例，中位年份为 1993 年。根据筛查标准，PSA 筛查在 23.2-29.2% 的病例和 21.8-26.1% 的对照中是明显的。对于最严格的标准，如果进行过筛查，未调整的、匹配的前列腺癌死亡比值比为 1.09（95% CI 0.76 至 1.60），对于最宽松的标准为 1.19（95% CI，0.85 至 1.66）。对合并症和教育水平进行调整后，这些值没有显着差异。年龄或种族之间没有显着的相互作用。结论：从 1989 年到 2000 年，使用曾经/从未测试列表进行 PSA 筛查并不能保护新泽西男性免受前列腺癌死亡。
BACKGROUND: There is no available evidence from randomized trials that early detection of prostate cancer improves health outcomes, but the prostate-specific antigen (PSA) test is commonly used to screen men for prostate cancer.OBJECTIVE: The objective of the study is to see if screening with PSA decreases mortality from prostate cancer.DESIGN, SETTING, AND PARTICIPANTS: This is a case-control study using one-to-one matching on race, age, and time of availability of exposure to PSA screening. Decedents, 380, from New Jersey Vital Statistics 1997 to 2000 inclusive, 55-79 years of age at diagnosis were matched to living controls without metastatic prostate cancer. Medical records were obtained from all providers, and we abstracted information about PSA tests from 1989 to the time of diagnosis in each index case.MEASUREMENTS: Measurements consist of a comparison of screening (yes, no) between cases and controls. Measure of association was the odds ratio.RESULTS: Eligible cases were diagnosed each year from 1989 to 1999 with the median year being 1993. PSA screening was evident in 23.2-29.2% of cases and 21.8-26.1% of controls depending on the screening criteria. The unadjusted, matched odds ratio for dying of prostate cancer if ever screened was 1.09 (95% CI 0.76 to 1.60) for the most restrictive criteria and 1.19 (95% CI, 0.85 to 1.66) for the least restrictive. Adjustment for comorbidity and education level made no significant differences in these values. There were no significant interactions by age or race.CONCLUSIONS: PSA screening using an ever/never tabulation for tests from 1989 until 2000 did not protect New Jersey men from prostate cancer mortality.