Oberaigner Willi, Horninger Wolfgang, Klocker Helmut, Schönitzer Dieter, Stühlinger Wolf, Bartsch Georg
Cancer Registry of Tyrol, Innsbruck, Austria.
Am J Epidemiol. 2006 Aug 15;164(4):376-84. doi: 10.1093/aje/kwj213. Epub 2006 Jul 7.
The objective of this study was to analyze in detail the time trend in prostate cancer mortality in the population of Tyrol, Austria. In Tyrol, prostate-specific antigen tests were introduced in 1988-1989 and, since 1993, have been offered to all men aged 45-74 years free of charge. More than three quarters of all men in this age group had at least one such test in the last decade. The authors applied the age-period-cohort model by Poisson regression to mortality data covering more than three decades, from 1970 to 2003. For Tyrol, the full model with age and period and cohort terms fit fairly well. Period terms showed a significant reduction in prostate cancer mortality in the last 5 years, with a risk ratio of 0.81 (95% confidence interval: 0.68, 0.98) for Tyrol; for Austria without Tyrol, no effect was seen, with a risk ratio of 1.00 (95% confidence interval: 0.95, 1.05). Each was compared with the mortality rate in the period 1989-1993. Although the results of randomized screening trials are not expected until 2008-2010, these findings support the evidence that prostate-specific antigen testing offered to a population free of charge can reduce prostate cancer mortality.
本研究的目的是详细分析奥地利蒂罗尔州人群中前列腺癌死亡率的时间趋势。在蒂罗尔州，1988 - 1989年引入了前列腺特异性抗原检测，自1993年起，向所有45 - 74岁的男性免费提供该检测。在过去十年中，该年龄组超过四分之三的男性至少接受过一次此类检测。作者通过泊松回归的年龄 - 时期 - 队列模型，对1970年至2003年这三十多年间的死亡率数据进行分析。对于蒂罗尔州，包含年龄、时期和队列项的完整模型拟合得相当好。时期项显示，在过去5年中，蒂罗尔州前列腺癌死亡率显著降低，风险比为0.81（95%置信区间：0.68，0.98）；对于不包括蒂罗尔州的奥地利，未观察到影响，风险比为1.00（95%置信区间：0.95，1.05）。每项均与1989 - 1993年期间的死亡率进行比较。尽管随机筛查试验的结果预计要到2008 - 2010年才会得出，但这些发现支持了以下证据：向人群免费提供前列腺特异性抗原检测可降低前列腺癌死亡率。
