Scales Charles D, Moul Judd W, Curtis Lesley H, Elkin Eric P, Hughes M E, Carroll Peter R
Duke Prostate Center, Division of Urology, Department of Surgery, Duke University Medical Center, Durham, North Carolina 27710, USA.
Urology. 2007 Dec;70(6):1162-7. doi: 10.1016/j.urology.2007.08.011.
Baby Boomers (those born in 1946 to 1964) are thought to place a high value on quality of life, and have a higher propensity to consume healthcare services than previous generations. We sought to characterize prostate cancer (CaP) presentation among this group, and determine whether treatment patterns differ between Baby Boomers and the preceding generation.
We defined two birth cohorts: men born in 1927 to 1945 (pre-Boomers) and Baby Boomers. Our study cohort included men less than 65 years old, diagnosed with CaP between 1999 and 2003 (Baby Boomers, n = 812; pre-Boomers, n = 1843). We compared the two groups for clinical presentation, sociodemographics, and primary treatment, controlling for age effects. The primary endpoint was selection of radical prostatectomy as primary treatment.
Most Baby Boomers were diagnosed with stage T1 disease (466, 61%), biopsy Gleason sums less than 7 (572, 73%), and prostate-specific antigen levels of 4.1 to 10.0 (509, 66%). This presentation was not clinically different from pre-Boomers. Baby Boomers had higher socioeconomic status than pre-Boomers. On multivariate analysis, Baby Boomers were more likely to undergo radical prostatectomy as primary therapy (odds ratio [OR] 1.63, 95% confidence interval [CI] 1.13 to 2.35). Controlling for age effects, however, there were no significant differences in treatment choice (OR 0.86, 95% CI 0.40 to 1.87) or sociodemographics between these groups.
Differences in CaP presentation and treatment between Baby Boomers and pre-Boomers may be related to age at diagnosis rather than innate differences in behavior. As more Baby Boomers are diagnosed with CaP, further research will be required to characterize this generation's impact on CaP care.
婴儿潮一代（出生于1946年至1964年）被认为高度重视生活质量，且比前几代人有更高的医疗服务消费倾向。我们试图描述这一群体中前列腺癌（CaP）的表现，并确定婴儿潮一代与前一代在治疗模式上是否存在差异。
我们定义了两个出生队列：出生于1927年至1945年的男性（婴儿潮前一代）和婴儿潮一代。我们的研究队列包括年龄小于65岁、在1999年至2003年期间被诊断为CaP的男性（婴儿潮一代，n = 812；婴儿潮前一代，n = 1843）。我们比较了两组的临床表现、社会人口统计学特征和主要治疗方法，并控制了年龄因素的影响。主要终点是选择根治性前列腺切除术作为主要治疗方法。
大多数婴儿潮一代被诊断为T1期疾病（466例，61%），活检Gleason评分小于7（572例，73%），前列腺特异性抗原水平为4.1至10.0（509例，66%）。这种表现与婴儿潮前一代在临床上没有差异。婴儿潮一代的社会经济地位高于婴儿潮前一代。在多变量分析中，婴儿潮一代作为主要治疗接受根治性前列腺切除术的可能性更大（优势比[OR]为1.63，95%置信区间[CI]为1.13至2.35）。然而，在控制年龄因素的影响后，这些组之间在治疗选择（OR为0.86，95%CI为0.40至1.87）或社会人口统计学特征方面没有显著差异。
婴儿潮一代与婴儿潮前一代在CaP表现和治疗方面的差异可能与诊断时的年龄有关，而不是行为上的固有差异。随着越来越多的婴儿潮一代被诊断为CaP，需要进一步研究来描述这一代人对CaP护理的影响。
