15-Year Followup of a Population Based Prostate Cancer Screening Study
15-Year Followup of a Population Based Prostate Cancer Screening Study
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DOI：
10.1016/j.juro.2008.11.115
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发表时间：
2009-04-01
影响因子：
6.6
通讯作者：
Gustafsson, Ove
中科院分区：
文献类型：
--
作者：
Kiellman, Anders;Akre, Olof;Gustafsson, Ove
目的：我们评估了长期生存的与会者和nonattendees的1-time screening for prostate cancer.Materials and Methods：共2,400名男性55至70岁，在1988年被随机选择，并邀请到前列腺癌的筛查。在受邀的1，782名男性（74%）中，对筛选参与者进行了直肠指检、经直肠超声和前列腺特异性抗原分析。当怀疑患有癌症时，进行前列腺活检。共65例前列腺癌患者通过该程序检测到。整个源人口包括27，204名男性，包括618名非与会者（26%），前列腺癌的诊断和生存15 years.Results：发病率比采用泊松回归模型计算。当将所有受邀男性与源人群进行比较时，我们发现该筛查程序对前列腺癌和其他死因的死亡风险无影响（发生率比分别为1.10，95% CI 0.83-1.46和0.98，95% CI 0.92-1.05）。然而，参加筛查项目与前列腺癌以外原因的死亡风险显著降低相关（与源人群发病率比0.82，95%CI 0.76-0.90）。相比之下，相应的发病率比在nonattendees为1.53（95%CI 1.37-1.71）。结论：我们没有发现这种特定的筛选程序的有益效果的证据，但强有力的证据表明，在筛选与会者和nonattendees的总生存率的差异。在解释以前和即将进行的关于筛查计划效果的研究时，应考虑这些发现。
Purpose: We evaluated long-term survival in attendees and nonattendees of a 1-time screening for prostate cancer.Materials and Methods: A total of 2,400 men 55 to 70 years old in 1988 were randomly selected and invited to a screening for prostate cancer. Of the invited men 1,782 (74%) attended, Screening attendees were examined with digital rectal examination, transrectal ultrasound and prostate specific antigen analysis. When cancer was suspected, prostate biopsies were taken. A total of 65 men with prostate cancer were detected by this procedure. The entire source population comprising 27,204 men, including 618 nonattendees (26%), was followed for prostate cancer diagnosis and survival for 15 years.Results: Incidence rate ratios were calculated using Poisson regression models. We found no effect of this screening procedure on the risk of death from prostate cancer and other causes of death (incidence rate ratio 1.10, 95% CI 0.83-1.46 and 0.98, 95% CI 0.92-1.05, respectively) when comparing all invited men with the source population. However, attending the screening program was associated with a significantly decreased risk of death from causes other than prostate cancer (vs source population incidence rate ratio 0.82, 95% CI 0.76-0.90). In contrast, the corresponding incidence rate ratio in nonattendees was 1.53 (95% CI 1.37-1.71).Conclusions: We found no evidence of a beneficial effect of this specific screening procedure but strong evidence of a difference in overall survival in screening attendees and nonattendees. These findings should be considered when interpreting previous and upcoming studies of the effect of screening programs.