[法国的前列腺特异性抗原检测、活检以及前列腺癌和良性前列腺增生]

[PSA testing, biopsy and cancer and benign prostate hyperplasia in France].

作者信息

Tuppin P, Samson S, Fagot-Campagna A, Lukacs B, Alla F, Allemand H, Paccaud F, Thalabard J-C, Vicaut E, Vidaud M, Millat B

机构信息

Caisse nationale d'assurance maladie des travailleurs salariés (CNAMTS), direction de la stratégie des études et des statistiques, 26-50, avenue du Professeur-André-Lemierre, 75986 Paris cedex 20, France.

出版信息

Prog Urol. 2014 Jul;24(9):572-80. doi: 10.1016/j.purol.2014.03.004. Epub 2014 Apr 16.

DOI:10.1016/j.purol.2014.03.004

PMID:24975792

Abstract

INTRODUCTION

Prostate-specific antigen (PSA) testing is high in France. The aim of this study was to estimate their frequency and those of biopsy and newly diagnosed cancer (PCa) according to the presence or absence of treated benign prostatic hyperplasia (BPH).

PATIENTS AND METHODS

This study concerned men 40 years and older covered by the main French national health insurance scheme (73 % of all men of this age). Data were collected from the national health insurance information system (SNIIRAM). This database comprehensively records all of the outpatient prescriptions and healthcare services reimbursed. This information are linked to data collected during hospitalisations.

RESULTS

The frequency of men without diagnosed PCa (10.9 millions) with at least one PSA test was very high in 2011 (men aged 40 years and older: 30 %, 70-74 years: 56 %, 85 years and older: 33 % and without HBP: 25 %, 41 % and 19 %). Men with treated BPH totalized 9 % of the study population, but 18 % of the men with at least one PSA test, 44 % of those with at least one prostate biopsy and 40 % of those with newly managed PCa. Over a 3-year period, excluding men with PCa, 88 % of men with BPH had at least one PSA test and 52 % had three or more PSA tests versus 52 % and 15 % for men without BPH. One year after PSA testing, men of 55-69 years with BPH more frequently underwent prostate biopsy than those without BPH (5.4 % vs 1.8 %) and presented PCa (1.9 % vs 0.9 %).

CONCLUSIONS

PSA testing frequencies in France are very high even after exclusion of men with BPH, who can be a group with more frequent managed PCa.

LEVEL OF EVIDENCE

摘要

引言

法国前列腺特异性抗原（PSA）检测率很高。本研究的目的是根据是否接受过良性前列腺增生（BPH）治疗，估算PSA检测、活检以及新诊断癌症（PCa）的频率。

患者与方法

本研究涉及法国主要国家健康保险计划覆盖的40岁及以上男性（占该年龄段所有男性的73%）。数据从国家健康保险信息系统（SNIIRAM）收集。该数据库全面记录了所有门诊处方和已报销的医疗服务。这些信息与住院期间收集的数据相关联。

结果

2011年，未诊断出PCa的男性（1090万）中至少进行过一次PSA检测的频率非常高（40岁及以上男性：30%，70 - 74岁：56%，85岁及以上：33%；未患HBP者：25%、41%和19%）。接受过BPH治疗的男性占研究人群的9%，但在至少进行过一次PSA检测的男性中占18%，在至少进行过一次前列腺活检的男性中占44%，在新确诊PCa的男性中占40%。在3年期间，排除患有PCa的男性，88%患有BPH的男性至少进行过一次PSA检测，52%进行过三次或更多次PSA检测，而未患BPH的男性分别为52%和15%。PSA检测一年后，55 - 69岁患有BPH的男性比未患BPH的男性更频繁地接受前列腺活检（5.4%对1.8%），且PCa发病率更高（1.9%对0.9%）。