Sociedade Brasileira de Urologia, Section Sao Paulo, Brazil.
Int Braz J Urol. 2012 Mar-Apr;38(2):155-64; discussion 164-6. doi: 10.1590/s1677-55382012000200003.
To describe the epidemiological features and patterns of initial care for prostate cancer at public and private institutions in the State of Sao Paulo, Brazil.
A total of 1,082 physicians affiliated to the Sao Paulo Section of the Brazilian Society of Urology were invited to participate in this cross-sectional, web-based survey. Between September 2004 and September 2005, participating urologists entered data on demographic, clinical and pathological characteristics of patients diagnosed with prostate cancer in their practice. Data on patients attended at public institutions were analyzed and compared with those patients attended at private practice.
One hundred and ten society members contributed with data from 1915 patients, 1026 (53.6%) of whom from public institutions. When compared with patients attended at private institutions, those attended at public institutions were older and more likely to be black, had higher serum prostate specific antigen (PSA) levels, had a higher probability of being diagnosed with metastatic disease, but were less likely to undergo prostatectomy (all P < 0.001). In multivariate analysis, age, biopsy Gleason score, and being attended at a public institution were independently associated with metastatic disease upon diagnosis. The significant predictors of nonsurgical treatment were age, black race, and higher serum levels of PSA.
A statewide registry provides valuable information regarding patient demographics, clinical features, and patterns of care. The results of this study suggest that significant disparities exist for patients with prostate cancer attended at different health-care systems. The relative contribution of biological versus socioeconomic features remains uncertain.
描述巴西圣保罗州公立和私立机构前列腺癌初始治疗的流行病学特征和模式。
共邀请了 1082 名隶属于巴西泌尿外科学会圣保罗分会的医生参与这项横断面、基于网络的调查。在 2004 年 9 月至 2005 年 9 月期间，参与的泌尿科医生输入了他们实践中诊断为前列腺癌患者的人口统计学、临床和病理特征数据。分析了在公立机构就诊的患者的数据，并与在私人诊所就诊的患者进行了比较。
110 名学会成员提供了来自 1915 名患者的数据，其中 1026 名（53.6%）来自公立机构。与在私立机构就诊的患者相比，在公立机构就诊的患者年龄更大，更可能是黑人，血清前列腺特异性抗原（PSA）水平更高，更有可能被诊断为转移性疾病，但接受前列腺切除术的可能性较小（均 P < 0.001）。在多变量分析中，年龄、活检 Gleason 评分和在公立机构就诊与诊断时的转移性疾病独立相关。非手术治疗的显著预测因素是年龄、黑种人种族和更高的血清 PSA 水平。
全州范围的登记提供了有关患者人口统计学、临床特征和治疗模式的有价值信息。这项研究的结果表明，在不同医疗保健系统就诊的前列腺癌患者之间存在显著差异。生物学和社会经济特征的相对贡献仍不确定。
