Uptake of prostate-specific antigen testing for early prostate cancer detection in Sweden
Uptake of prostate-specific antigen testing for early prostate cancer detection in Sweden
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DOI：
10.1002/ijc.25846
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发表时间：
2011-10-15
影响因子：
6.4
通讯作者：
Stattin, Par
中科院分区：
文献类型：
--
作者：
Jonsson, Hakan;Holmstrom, Benny;Stattin, Par
我们研究的目的是估计整个国家前列腺特异性抗原 (PSA) 检测的采用情况，包括时间趋势和地理差异。瑞典癌症登记处关于 1980 年至 2007 年间前列腺癌发病率的数据以及前列腺癌筛查欧洲随机研究 (ERSPC)（一项基于人群的 PSA 筛查研究）哥德堡分部公布的数据，被用于前列腺癌发病率变化的两个模型中，作为瑞典所有 24 个县 PSA 检测采用情况的代理。估计年度 PSA 检测（不考虑前几年的暴露情况）在 2004 年达到了所有男性 12% 的峰值，此后下降到 2007 年的 6%，各县之间的差异从不到 5% 到 20%。假设每年接受 PSA 检测的男性以前没有接受过 PSA 检测，瑞典 55-69 岁男性中 PSA 检测的累计接受率从 1997 年的零增加到 2007 年的 56%。我们的研究表明，可以根据前列腺癌的发病率模式来估计人群中 PSA 检测的接受率。尽管瑞典有统一的医疗保健系统，但 PSA 检测的采用率存在很大的地域差异，并且在研究期间，尽管没有针对基于 PSA 的前列腺癌筛查的全国性建议，PSA 检测的采用率大幅增加。
The aim of our study was to estimate uptake of prostate-specific antigen (PSA) testing in an entire country, including time trends and geographical differences. Data from the Swedish Cancer Register on prostate cancer incidence between 1980 and 2007 and published data from the Gothenburg branch of the European randomized study of screening for prostate cancer (ERSPC), a population-based PSA screening study, were used in two models of changes in incidence of prostate cancer as a proxy for uptake of PSA testing in all 24 Swedish counties. The estimated annual PSA testing, irrespective of previous years' exposure, reached a peak of 12% of all men in 2004 and decreased thereafter to 6% in 2007 and varied from less than 5 to 20% between counties. Under the assumption that men who underwent annual PSA testing were previously unexposed to PSA testing, the cumulated uptake of PSA testing in men aged 55-69 years in Sweden increased from zero in 1997 to 56% in 2007. Our study shows that it is possible to estimate uptake of PSA testing in the population from the prostate cancer incidence pattern. There were large geographical variations in uptake of PSA testing despite a uniform health care system in Sweden and there was a substantial increase in the uptake of PSA testing during the study period, despite that there were no national recommendations for PSA-based prostate cancer screening.