Asymptomatic incidence and duration of prostate cancer.
Asymptomatic incidence and duration of prostate cancer.
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DOI：
10.1093/oxfordjournals.aje.a009698
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发表时间：
1998-10
影响因子：
5
通讯作者：
Ruth Etzioni;R. Cha;E. Feuer;O. Davidov
中科院分区：
文献类型：
--
作者：
Ruth Etzioni;R. Cha;E. Feuer;O. Davidov
前列腺癌被认为是一种相对于其在人群中的临床发病率具有极高患病率的疾病。临床前发病率和持续时间的结合可能产生这种现象，这对试图了解疾病自然史和开发有效筛查策略的研究人员来说是非常感兴趣的。在这篇文章中，作者提出了年龄特异性前列腺癌无症状发病率和平均临床前病程的估计。方法学方法是首先使用来自1941年至1964年进行的尸检研究的临床前患病率数据和来自国家癌症研究所的监测、流行病学和最终结果（SEER）计划的1960年至1986年的临床发病率数据估计新的（AI期）前列腺癌的年龄特异性发病率。然后，将临床前患病率估计值除以推导出的临床前发病率估计值，得到无症状疾病平均持续时间的估计值。估计白色男性的平均持续时间为11至12年，黑人似乎比白人短约1年。临床前和临床疾病的终生风险比较表明，如果临床发病率保持在1984-1986年（在人群中引入前列腺特异性抗原（PSA）筛查之前）观察到的水平，则约75%的前列腺癌将永远不会被诊断出来。
Prostate cancer is known as a disease with an extremely high prevalence relative to its clinical incidence in the population. The combination of preclinical incidence and duration that could yield this phenomenon is of tremendous interest to researchers trying to understand the natural history of the disease and to develop efficient screening strategies. In this article, the authors present estimates of the age-specific asymptomatic incidence and average preclinical duration of prostate cancer. The methodological approach is to first estimate the age-specific incidence of new (stage AI) prostate cancers using preclinical prevalence data from autopsy studies performed between 1941 and 1964 and clinical incidence data for the years 1960-1986 from the Surveillance, Epidemiology, and End Results (SEER) program of the National Cancer Institute. Then, the preclinical prevalence estimates are divided by the derived preclinical incidence estimates to yield estimates of the average duration of asymptomatic disease. The estimated mean duration among white men is between 11 and 12 years and appears to be approximately 1 year shorter for blacks than for whites. Comparison of the lifetime risks of preclinical and clinical disease suggests that approximately 75% of prostate cancers will never become diagnosed if clinical incidence remains at levels observed in 1984-1986, prior to the introduction of prostate-specific antigen (PSA) screening in the population.