Department of Biological Sciences, Clark Atlanta University, Atlanta, GA, USA.
Clin Epidemiol. 2012;4:19-32. doi: 10.2147/CLEP.S23536. Epub 2012 Jan 10.
To date there has not been any nationwide age-standardized incidence data reported for prostate cancer in Nigeria. We examined and integrated diverse trends in the age-specific incidence of prostate cancer into a comprehensive trend for Nigeria, and examined how best the existing data could generate a countrywide age-standardized incidence rate for the disease.
Data were obtained from studies undertaken between 1970 and 2007 in referral hospital-based cancer registries. Records from at least one tertiary hospital in each of the six geopolitical zones of Nigeria were examined retrospectively. Data were also reported for the rural population in cross-sectional prospective studies. Age-standardized incidence rates and the annual incidence of disease were calculated.
Higher incidence rates for prostate cancer during this period were recorded for patients aged 60-69 years and 70-79 years, with a lower incidence rate for patients aged younger than 50 years. An exponential annual incidence rate of disease was observed in the 50-79 year age group and peaked at 70-79 years before dropping again at age 80 years. The results showed metastasis in more than half of these hospital-based prostate tumors.
Our results suggest that prostate cancer occurs at a relatively young age in Nigerians and that hospital-based registry reports may not appropriately reflect the incidence of the disease in Nigeria. A countrywide screening program is urgently needed. Finally, the difference in reported stages of disease found in Nigerians and African-Americans versus Caucasians suggests biological differences in the prognosis. Nigeria may thus typify one of the ancestral populations that harbor inherited genes predisposing African-Americans to high-risk prostate cancer.
目前为止,尼日利亚还没有关于前列腺癌的全国年龄标准化发病率数据。我们检验和综合了不同年龄段前列腺癌的发病趋势,得出了尼日利亚的综合发病趋势,并研究了如何最好地利用现有数据得出该疾病的全国年龄标准化发病率。
数据来源于 1970 年至 2007 年间在转诊医院癌症登记处进行的研究。我们回顾性地检查了尼日利亚六个地理政治区的每家三级医院的记录。数据还来自于农村地区的横断面前瞻性研究。我们计算了年龄标准化发病率和疾病的年发病率。
在此期间,60-69 岁和 70-79 岁的患者前列腺癌发病率较高,50 岁以下的患者发病率较低。在 50-79 岁年龄组中,观察到疾病的年发病率呈指数增长,并在 70-79 岁达到峰值,然后在 80 岁再次下降。结果显示,这些基于医院的前列腺肿瘤中有一半以上发生了转移。
我们的结果表明,尼日利亚人的前列腺癌发病年龄相对较早,而基于医院的登记报告可能不能适当反映该疾病在尼日利亚的发病率。尼日利亚急需开展全国性的筛查计划。最后,我们发现尼日利亚人、非洲裔美国人和高加索人之间报告的疾病分期存在差异,这表明在预后方面存在生物学差异。尼日利亚可能代表了一个具有遗传基因的祖先群体,这些遗传基因使非洲裔美国人易患高危前列腺癌。