Melia Jane, Moss Sue, Johns Louise
Cancer Screening Evaluation Unit, Institute of Cancer Research, Sutton, Surrey, UK.
BJU Int. 2004 Jul;94(1):51-6. doi: 10.1111/j.1464-4096.2004.04832.x.
To assess the rate of prostate-specific antigen (PSA) testing for prostate cancer in general practice in asymptomatic and symptomatic patients.
The cross-sectional study took place in England and Wales, was population-based and covered 469 159 men aged 45-84 years. Pathology data on PSA tests requested between 19 November 1999 and 31 May 2002 by general practitioners (GPs) were provided by 28 pathology laboratories. The practices recorded reasons for the tests between 1 December 2001 and 31 May 2002. In all, 391 practices in which all GP partners participated were included in the analyses.
The overall annual rate of testing in men with no previous diagnosis of prostate cancer was estimated to be 6%, of which the annual rates of asymptomatic, symptomatic and re-testing were 2.0%, 2.8% and 1.2%, respectively, after adjusting for missing values. The rate decreased with increasing social deprivation, and with increasing proportions of black and Asian populations. The overall rate of PSA testing increased significantly from 1999 to 2002.
If the recommendations of the National Health Service Prostate Cancer Risk Management Programme were applied, 14% of asymptomatic tests and 23% of symptomatic tests would have led to a referral. As the rate of PSA testing is increasing and there are uncertainties about the benefit of screening, the workload and costs in general practice and hospitals should be monitored.
评估在全科医疗中对无症状和有症状患者进行前列腺癌前列腺特异性抗原（PSA）检测的比率。
这项横断面研究在英格兰和威尔士开展，以人群为基础，涵盖了469159名年龄在45 - 84岁的男性。28家病理实验室提供了1999年11月19日至2002年5月31日期间全科医生（GP）所要求的PSA检测的病理数据。这些医疗机构记录了2001年12月1日至2002年5月31日期间进行检测的原因。总共391家所有GP合伙人都参与的医疗机构被纳入分析。
在既往无前列腺癌诊断的男性中，总体年度检测率估计为6%，在对缺失值进行调整后，无症状、有症状和复查的年度检测率分别为2.0%、2.8%和1.2%。该比率随着社会剥夺程度的增加以及黑人和亚洲人口比例的增加而降低。从1999年到2002年，PSA检测的总体比率显著上升。
如果应用国家医疗服务体系前列腺癌风险管理计划的建议，14%的无症状检测和23%的有症状检测将会导致转诊。由于PSA检测比率在上升，且筛查的益处存在不确定性，应监测全科医疗和医院的工作量及成本。
