Fairley L, Baker M, Whiteway J, Cross W, Forman D
Northern and Yorkshire Cancer Registry and Information Service, Level 6, Bexley Wing, St James's Institute of Oncology, St James's Hospital, Beckett Street, Leeds, LS9 7TF, UK.
Br J Cancer. 2009 Dec 1;101(11):1839-45. doi: 10.1038/sj.bjc.6605424. Epub 2009 Nov 10.
Our objective was to analyse variation in non-metastatic prostate cancer management in the Northern and Yorkshire region of England.
We included 21,334 men aged > or = 55, diagnosed between 2000 and 2006. Principal treatment received was categorised into radical prostatectomy (11%), brachytherapy (2%), external beam radiotherapy (16%), hormone therapy (42%) and no treatment (29%).
The odds ratio (OR) for receiving a radical prostatectomy was 1.53 in 2006 compared with 2000 (95% CI 1.26-1.86), whereas the OR for receiving hormone therapy was 0.57 (0.51-0.64). Age was strongly associated with treatment received; radical treatments were significantly less likely in men aged > or = 75 compared with men aged 55-64 years, whereas the odds of receiving hormone therapy or no treatment were significantly higher in the older age group. The OR for receiving radical prostatectomy, brachytherapy or external beam radiotherapy were all significantly lower in the most deprived areas when compared with the most affluent (0.64 (0.55-0.75), 0.32 (0.22-0.47) and 0.83 (0.74-0.94), respectively) whereas the OR for receiving hormone therapy was 1.56 (1.42-1.71).
This study highlights the variation and inequalities that exist in the management of non-metastatic prostate cancer in the Northern and Yorkshire region of England.
我们的目标是分析英格兰北部和约克郡地区非转移性前列腺癌治疗的差异。
我们纳入了2000年至2006年间诊断出的21334名年龄≥55岁的男性。接受的主要治疗分为根治性前列腺切除术（11%）、近距离放射疗法（2%）、外照射放疗（16%）、激素疗法（42%）和未治疗（29%）。
与2000年相比，2006年接受根治性前列腺切除术的比值比（OR）为1.53（95%可信区间1.26 - 1.86），而接受激素疗法的OR为0.57（0.51 - 0.64）。年龄与接受的治疗密切相关；与55 - 64岁的男性相比，年龄≥75岁的男性接受根治性治疗的可能性显著降低，而在老年组中接受激素疗法或未治疗的几率显著更高。与最富裕地区相比，最贫困地区接受根治性前列腺切除术、近距离放射疗法或外照射放疗的OR均显著更低（分别为0.64（0.55 - 0.75）、0.32（0.22 - 0.47）和0.83（0.74 - 0.94）），而接受激素疗法的OR为1.56（1.42 - 1.71）。
本研究突出了英格兰北部和约克郡地区非转移性前列腺癌治疗中存在的差异和不平等。
