Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
Eur J Cancer. 2010 Nov;46(17):3053-60. doi: 10.1016/j.ejca.2010.09.012.
To describe the variation in PSA level by age group and screening round in the ERSPC centres and the variation in cancer detection rates in relation to the underlying prostate cancer incidence.
Individual data on men invited for the first and second screening rounds according to protocol (excluding early recalls and interval cancers) were obtained from the central database of the ERSPC (cut-off date 31st December 2006). Data were compared between and within centres for the core age group (55-69 at entry). The cancer detection rate (CDR) was compared with the expected background prostate cancer incidence rate in the absence of screening adjusted for the incidence rate in non-attenders and the control arm (IRS).
Mean PSA values in the age groups 55-59 years and 65-69 years showed little variation by centre, except for the Dutch centre, where an increase from 1.6 to 1.8 ng/ml and a decline from 2.9 to 2.5ng/ml was observed, respectively. Most tumours were detected at the PSA range 4.0-9.9 ng/ml, with a shift to more cancer detection at 3.0-3.9 ng/ml in the second screening round. There was high variability in the CDR between the centres in both the first (16-46 per 1000) and the second screening rounds (14-50 per 1000). Although the ratio CDR/IRS was less variable, it is somewhat lower in Italy and Switzerland (12 and 14,respectively) and higher in the Netherlands (28), than in most other centres and in Belgium the ratio increased markedly, from 20 to 44 between the first and second rounds.
There was no clear evidence of a relationship between the underlying incidence and mean PSA levels at screening or the cancer detection rate.
描述 ERSPC 中心按年龄组和筛查轮次划分的 PSA 水平变化，以及与潜在前列腺癌发病率相关的癌症检出率变化。
根据方案（不包括早期召回和间期癌），从 ERSPC 中央数据库中获得邀请参加第一和第二轮筛查的男性个体数据（截止日期为 2006 年 12 月 31 日）。在中心之间和中心内部比较核心年龄组（入组时 55-69 岁）的数据。将癌症检出率（CDR）与无筛查时的预期背景前列腺癌发病率进行比较，该发病率根据不参与者和对照组的发病率进行了调整（IRS）。
55-59 岁和 65-69 岁年龄组的平均 PSA 值除荷兰中心外，各中心之间变化不大，荷兰中心的 PSA 值分别从 1.6ng/ml 增加到 1.8ng/ml，从 2.9ng/ml 下降到 2.5ng/ml。大多数肿瘤在 PSA 范围 4.0-9.9ng/ml 时被检出，第二轮筛查时 PSA 范围 3.0-3.9ng/ml 时的癌症检出率增加。在第一轮（16-46/1000）和第二轮（14-50/1000）筛查中，各中心之间的 CDR 差异很大。尽管 CDR/IRS 的变异性较小，但意大利和瑞士（分别为 12 和 14）的比值略低，荷兰的比值（28）较高，比利时的比值明显升高，从第一轮的 20 升至第二轮的 44。
在潜在发病率与筛查时的平均 PSA 水平或癌症检出率之间没有明显的关系。
