前列腺特异性抗原正常值下限降低对泌尿外科转诊率的影响。

The effect of lowering the prostate-specific antigen normal cutoff on referral rates to urology.

机构信息

Department of Family Medicine and Community Health, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, Freehold, NJ 07728, USA.

出版信息

J Am Board Fam Med. 2012 Nov-Dec;25(6):927-9. doi: 10.3122/jabfm.2012.06.120172.

DOI:10.3122/jabfm.2012.06.120172

PMID:23136335

Abstract

BACKGROUND

Routine prostate cancer screening is controversial, yet the use of prostate-specific antigen (PSA) for screening is likely to continue. Our hospital laboratory decreased the cutoff for normal PSA to 2.5 ng/mL on July 2, 2007, based on the National Comprehensive Screening Network recommendations. The purpose of this study was to determine if referral rates to urology increased after this change.

METHODS

We queried our electronic health records to obtain the number of total screening PSA and abnormal PSA and subsequent referrals to urology in the 20-month periods before and after the change in PSA cutoff.

RESULTS

There was no significant difference between the percentage of total screening PSA that resulted in a referral to urology after the change than before (7 of 199 [3.5%] vs 8 of 113 [7.1%]; P = .16). The percentage of abnormal PSA (as defined in the respective time periods) that were referred to urology actually decreased after the change (7 of 29 [24.1%] vs 6 of 10 [60.0%]; P = .04); however, when considering only PSA >4.0 ng/mL in each time period, there was no difference in percentage of referrals between the 2 periods.

CONCLUSIONS

Contrary to expectations, lowering the cutoff for normal PSA did not increase referrals to urology.

摘要

背景

前列腺癌常规筛查存在争议，但基于国家综合筛查网络的建议，前列腺特异性抗原（PSA）用于筛查的可能性仍在继续。我院实验室于 2007 年 7 月 2 日将正常 PSA 的截止值降低至 2.5ng/mL。本研究旨在确定在此更改之后，泌尿科的转诊率是否增加。

方法

我们查询了电子健康记录，以获取 PSA 筛查和异常 PSA 以及随后转诊到泌尿科的总人数，分别在 PSA 截止值改变前后的 20 个月内。

结果

与更改之前相比，更改后导致泌尿科转诊的总筛查 PSA 的百分比没有显着差异（7/199[3.5%]与 8/113[7.1%]；P=.16）。实际上，更改后异常 PSA（在相应时间段内定义）被转诊到泌尿科的百分比降低（7/29[24.1%]与 6/10[60.0%]；P=.04）；然而，当仅考虑每个时间段内 PSA>4.0ng/mL 时，两个时间段之间的转诊百分比没有差异。