Wasson John H, Bubolz Thomas A, Yao Grace Lu, Barry Michael J
Center for the Aging, Dartmouth Medical School, Hanover, NH 03755-3862, USA.
Eff Clin Pract. 2002 May-Jun;5(3):137-42.
Authorities discourage prostate screening in men who are likely to die from causes other than prostate cancer.
Use of prostate biopsy-a proxy for screening-in men aged 65 and older with limited life expectancy (i.e., estimated to be less than 10 years).
Five percent samples of Part A (hospital) and Part B (physician) Medicare claims for 1993 through 1997.
22% of all Medicare beneficiaries who underwent a prostate biopsy had a limited life expectancy, corresponding to a rate of 1420 biopsies per 100,000. This rate did not change significantly between 1993 and 1997. For men with a life expectancy greater than 10 years, the biopsy rate was 2,360 per 100,000. Among men with limited life expectancy, in the year following the biopsy, 1.6% had radical prostatectomy and 2.3% had external-beam radiation. Thirty-nine percent were hospitalized.
A substantial proportion of prostate biopsies are being performed in men with a life expectancy of less than 10 years. These men are unlikely to benefit from the biopsy or subsequent treatment.
对于那些很可能死于前列腺癌以外原因的男性，官方不鼓励进行前列腺筛查。
对预期寿命有限（即估计少于10年）的65岁及以上男性使用前列腺活检（作为筛查的替代指标）。
1993年至1997年医疗保险A部分（医院）和B部分（医生）索赔的5%样本。
所有接受前列腺活检的医疗保险受益人中，22%预期寿命有限，相当于每10万人中有1420例活检。1993年至1997年期间，该比率没有显著变化。对于预期寿命超过10年的男性，活检率为每10万人2360例。在预期寿命有限的男性中，活检后的一年内，1.6%接受了根治性前列腺切除术，2.3%接受了外照射放疗。39%的人住院治疗。
相当一部分前列腺活检是在预期寿命少于10年的男性中进行的。这些男性不太可能从活检或后续治疗中获益。
