Incidence of prostate cancer diagnosis in the eras before and after serum prostate-specific antigen testing.
Incidence of prostate cancer diagnosis in the eras before and after serum prostate-specific antigen testing.
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DOI：
10.1001/jama.1995.03530180039027
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发表时间：
1995-11
期刊：
影响因子：
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通讯作者：
S. Jacobsen;S. Katusic;E. Bergstralh;J. E. Oesterling;Del Ohrt;G. Klee;C. Chute;M. Lieber
中科院分区：
文献类型：
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作者：
S. Jacobsen;S. Katusic;E. Bergstralh;J. E. Oesterling;Del Ohrt;G. Klee;C. Chute;M. Lieber
目的评估明尼苏达州奥姆斯特德县（Olmsted County） 1983年至1992年间前列腺癌的发病率，以描述自1987年将血清前列腺特异性抗原（PSA）检测引入社区医疗实践以来发生的长期变化。设计：以人群为基础的描述性流行病学研究，对生态和个体水平进行长期比较。研究背景：明尼苏达州奥姆斯特德县，罗切斯特流行病学项目对当地人口的健康状况进行被动监测。研究对象：从1983年到1992年，511例经活检证实的前列腺腺癌病例。我们回顾了所有病例的社区住院和门诊病历，以评估男性在诊断时的表现特征。经活检证实的前列腺癌的年龄调整发病率从1983年的64 / 10万人-年增加到1992年的216 / 10万人-年。增加主要发生在1987年至1988年之间，主要是器官局限性肿瘤。在同一时期，年龄在50岁及以上的男性中，特定年龄的发病率急剧上升。然而，在70岁及以上的男性中，前列腺癌发病率在1990年开始上升后下降。老年男性的这种下降与社区对PSA使用率的估计形成对比，社区对PSA使用率的估计显示，自1987年以来PSA使用率持续上升，1992年占老年人口的比例接近50%。结论：这些结果支持了最近前列腺癌增加的前提，部分原因是由于血清PSA检测的使用增加。此外，发病率的增加似乎是一种暂时现象，因为以前未确诊的病例已从以前的病例库中消失。最后，这些数据表明，就诊断阶段而言，早期检测工作可能有效地识别更多早期（较小）癌症。
OBJECTIVE To estimate the incidence of prostate cancer in Olmsted County, Minnesota, from 1983 through 1992 to describe the secular changes that have occurred since the introduction of serum prostate-specific antigen (PSA) testing to the community medical practice in 1987. DESIGN Population-based, descriptive epidemiological study with ecological and individual level comparisons over time. STUDY SETTING Olmsted County, Minnesota, where the Rochester Epidemiology Project provides passive surveillance of the population for health outcomes. SUBJECTS All 511 biopsy-proven incident cases of adenocarcinoma of the prostate diagnosed from 1983 through 1992. The community inpatient and outpatient medical records of all incident cases were reviewed to evaluate the presenting characteristics of men at the time of diagnosis. RESULTS The age-adjusted incidence of biopsy-proven prostate cancer increased from 64 per 100,000 person-years in 1983 to 216 per 100,000 person-years in 1992. The increase occurred primarily between 1987 and 1988 and was predominately for organ-confined tumors. The age-specific incidence increased dramatically in this same period among men aged 50 years and older. Among men aged 70 years and older, however, prostate carcinoma incidence rates declined after 1990 following the initial increase. This decline among older men contrasted with community-based estimates of PSA utilization rates, which demonstrated consistent increases since 1987 to nearly 50% of the older population in 1992. CONCLUSION These results support the premise that the recent increase in prostate cancer is due in part to the increased utilization of serum PSA testing. Further, the increased incidence appears to be a transient phenomenon due to the depletion of previously undiagnosed cases from the previous pool. Finally, these data suggest that, in terms of stage at diagnosis, early detection efforts may be effective in identifying more early stage (smaller) cancers.