PSA SCREENING AND PROSTATE CANCER MORTALITY

描述：(改编自申请人摘要)。前列腺特异性 前列腺癌抗原(PSA)筛查预防前列腺癌死亡和残疾 从1989年开始在美国广泛使用。《美国癌症》 该协会建议所有50岁以上的男性都要做这项血液测试 每年，有证据表明，大多数50-79岁的男性都有 至少做过一次测试。虽然筛查导致艾滋病患者数量大幅增加 癌症的诊断，以及随后的根治性前列腺手术，它的 预防这种疾病死亡的有效性尚未得到证实。前列腺癌 死亡率继续上升。一项以人群为基础的病例对照研究 PSA筛查是评估这一点的最及时的方法 主要的筛查方式。这些研究已经成功地用于 评估其他筛查模式，并基于这样一个概念：如果 筛查可以预防死亡，死者应该不太可能患有 比人口中可比的男性更容易被筛查。病例数将为55-79例 年，已婚，新泽西州男子，1998-2000年死于前列腺癌。 已婚对照将从随机数字拨号(55岁-)或 来自联邦医疗保险档案(65-79岁)，并将与年龄匹配的病例相匹配 和种族。将约谈病例和对照家庭，以确定所有 1989年以来的医疗保健来源，并获得审查这些来源的许可 PSA筛查记录。所有住院和门诊提供者将 联系以确定自1989年以来的PSA筛查情况。分析将 重点调查1989年至2005年期间是否筛查过病例 诊断。将在#年研究完全可比较的日历时间段 控制。保护范围(以前列腺癌的优势比来衡量 与筛查相关的癌症死亡小于1.0)将被计算 调整前后的潜在混杂因素。这项研究是 提议首次直接评估PSA的效力 前列腺癌死亡率筛查。

DESCRIPTION: (Adapted from Applicant's Abstract). Prostate specific antigen (PSA) screening to prevent death and disability from prostate cancer has come into widespread use in the U.S. since 1989. The American Cancer Society recommends that all men over age 50 have this blood test done annually, and there is evidence that a majority of 50-79 year old men have had the test at least once. While screening has led to a major increase in the diagnosis of cancer and, consequently, i radical prostate surgeries, its efficacy in preventing death from this disease is unproven. Prostate cancer mortality has continued to increase. A population-based, case-control study of PSA screening is proposed as the most timely approach to evaluate this major screening modality. These studies have been used successfully to evaluate other screening modalities and are predicated on the notion that if screening prevents mortality, the decedents should be less likely to have been screened than comparable men in the population. Cases will be 55-79 year old, married, New Jersey men, dying of prostate cancer in 1998-2000. Married controls will be selected from random digit dialing (age 55-64) or from Federal Medicare files (age 65-79) and will be matched to cases on age and race. Case and control families will be interviewed to ascertain all sources of medical care since 1989 and secure permission to review these records for PSA screening. All inpatient and outpatient providers will be contacted to ascertain instances of PSA screening since 1989. Analysis will focus on whether or not cases were screened from 1989 to the time of diagnosis. An exactly comparable calendar time period will be studied in controls. The extent of protection (measured as an odds ratio for prostate cancer death of less than 1.0) associated with screening will be calculated before and after adjustment for potential confounders. This study is proposed to provide the first direct estimate of the effectiveness of PSA screening on prostate cancer mortality.