Mukai Thomas Ostersen, Bro Flemming, Pedersen Knud Venborg, Vedsted Peter
Forskningsenheden for Almen Praksis, Aarhus Universitet, DK-8000 Arhus C, Denmark.
Ugeskr Laeger. 2010 Mar 1;172(9):696-700.
Prostate cancer (PC) is the most frequent type of cancer among Danish men and its incidence is rising. PC is often asymptomatic, which makes it very difficult to diagnose clinically. The general practitioner can use prostate-specific antigen (PSA) testing as a diagnostic tool in PC. The use of PSA testing has been recommended by the Danish Urological Society since 1997. Our objective was to study the application and results of PSA testing in the former County of Aarhus, Denmark, in the period 1995-2006.
We extracted data from the laboratory database, LABKA, and the National Patient Registry (NPR) during the period 1995 to 2006. Data were merged by civil registration number, and the unit ordering PSA was identified as general practice or specialized healthcare system. Furthermore, we categorized samples as incident, repeated normal, repeated raised samples, or controls.
The use of PSA increased 43-fold in this period and the proportion of samples ordered by general practice increased from 38.6% (95% confidence interval: 36.4-40.8%) in 1998 to 66.1% (65.4-66.8%) in 2006. The proportion of incident samples ordered by general practice, with results below four mikromol/l increased rapidly, whereas it decreased in the specialized healthcare system. In this population, the PC incidence increased the same period, but remained stable from 2004 onwards. Furthermore, we found that the mean number of tests per man per year increased in general practice.
PSA testing in general practice is conducted more frequently, a tendency which may be explained by more check-ups after PC treatment, watchful waiting and opportunistic screening.
前列腺癌（PC）是丹麦男性中最常见的癌症类型，其发病率正在上升。PC通常无症状，这使得临床诊断非常困难。全科医生可将前列腺特异性抗原（PSA）检测用作PC的诊断工具。自1997年以来，丹麦泌尿外科学会一直推荐使用PSA检测。我们的目的是研究1995 - 2006年期间丹麦奥胡斯郡PSA检测的应用情况和结果。
我们从实验室数据库LABKA和国家患者登记处（NPR）提取了1995年至2006年期间的数据。数据通过公民登记号进行合并，并将订购PSA的单位确定为全科医疗或专科医疗系统。此外，我们将样本分类为新发、重复正常、重复升高样本或对照。
在此期间，PSA检测的使用增加了43倍，全科医疗订购样本的比例从1998年的38.6%（95%置信区间：36.4 - 40.8%）增加到2006年的66.1%（65.4 - 66.8%）。全科医疗订购的新发样本中，结果低于4微摩尔/升的比例迅速增加，而在专科医疗系统中则下降。在该人群中，同期PC发病率上升，但从2004年起保持稳定。此外，我们发现全科医疗中每人每年的平均检测次数增加。
全科医疗中PSA检测更为频繁，这种趋势可能是由于PC治疗后的更多检查、观察等待和机会性筛查所致。
