Prostate Diseases Prevention and Treatment Research Centre, Jilin University, Changchun 130021, China.
Asian J Androl. 2011 Jul;13(4):574-8. doi: 10.1038/aja.2010.126. Epub 2011 May 9.
The aim of this study was to determine and examine the possible reasons for the difference in prostate cancer incidence between Asian men and North American men by literature review. Data regarding cancer incidence and mortality were obtained from the database of the International Agency for Research on Cancer (IARC). A literature review was conducted by studying related articles published in peer-reviewed journals such as the The New England Journal of Medicine, Journal of Clinical Oncology, A Cancer Journal for Clinicians and Asian Journal of Andrology. To evaluate the early diagnosis and survival rates, the mortality-to-incidence rate ratio (MR/IR) was calculated from the IARC data. By comparing prostate cancer data between Asian men and North American men, we found that differences in the incidence rate and MR/IR could be attributed largely to a lack of annual prostate cancer screening with serum prostate-specific antigen (PSA) in most Asian countries. It is likely that PSA screening also contributes significantly to the differences in prostate cancer mortality rates. Prostate cancer has the highest incidence rate among five common malignancies in Asian Americans. However, the MR/IR ratio of prostate cancer is the lowest among cancers. These data seem to further support the usefulness of PSA screening, even though the percentage of low risk cancers is greater in prostate cancer than in other cancers. The low incidence rate of prostate cancer does not reflect the actual statistics of this disease in Asia. The data from limited institutions in many Asian countries seem to bias the true incidence and mortality rates. To improve this situation, incorporating PSA screening for prostate cancer, as well as constructing a nationwide cancer registration system, will be helpful.
本研究旨在通过文献回顾确定并探讨亚洲男性和北美男性前列腺癌发病率差异的可能原因。癌症发病率和死亡率数据来自国际癌症研究机构（IARC）数据库。通过研究发表在同行评议期刊（如《新英格兰医学杂志》、《临床肿瘤学杂志》、《癌症临床医师杂志》和《亚洲男性学杂志》）上的相关文章进行文献回顾。为了评估早期诊断和生存率，我们从 IARC 数据计算了死亡率与发病率的比值（MR/IR）。通过比较亚洲男性和北美男性的前列腺癌数据，我们发现发病率和 MR/IR 的差异主要归因于大多数亚洲国家缺乏年度前列腺癌筛查和血清前列腺特异性抗原（PSA）检测。PSA 筛查可能也是导致前列腺癌死亡率差异的重要原因。在亚裔美国人的五种常见恶性肿瘤中，前列腺癌的发病率最高。然而，在癌症中，前列腺癌的 MR/IR 比值最低。这些数据似乎进一步支持 PSA 筛查的有效性，尽管与其他癌症相比，前列腺癌中低危癌症的比例更高。前列腺癌的低发病率并不能反映亚洲地区该疾病的实际统计数据。来自许多亚洲国家的有限机构的数据似乎存在偏差，导致真实的发病率和死亡率不准确。为了改善这种情况，将 PSA 筛查纳入前列腺癌，以及构建全国性的癌症登记系统，将有所帮助。
