Hu Jim C, Williams Stephen B, Carter Stacey C, Eggener Scott E, Prasad Sandip, Chamie Karim, Trinh Quoc-Dien, Sun Maxine, Nguyen Paul L, Lipsitz Stuart R
Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, CA.
Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX.
Urol Oncol. 2015 Feb;33(2):69.e29-34. doi: 10.1016/j.urolonc.2014.06.003. Epub 2014 Jul 10.
To perform a population-based analysis to characterize the effect of prostate-specific antigen (PSA) testing on oncologic outcomes in men diagnosed with prostate cancer.
We used the Surveillance, Epidemiology, and End Results-Medicare-linked data to identify 98,883 men diagnosed with prostate cancer from 1996 to 2007. We stratified frequency of PSA testing as none, 1 to 2, 3 to 5, and≥6 tests in the 5 years before prostate cancer diagnosis. We used propensity scoring methods to assess the effect of frequency of PSA testing on likelihood of (1) metastases at diagnosis and (2) overall mortality and prostate cancer-specific mortality.
In adjusted analyses, the likelihood of being diagnosed with metastatic prostate cancer decreased with greater frequency of PSA testing (none, 10.6; 1-2, 8.3; 3-5, 3.7; and≥6, 2.5 events per 100 person years, P<0.001). Additionally, greater frequency of PSA testing was associated with improved overall survival and prostate cancer-specific survival (P<0.001 for both).
Greater frequency of PSA testing in men 70 years of age or older in the 5 years before prostate cancer diagnosis is associated with lower likelihood of being diagnosed with metastatic prostate cancer and improved overall and prostate cancer-specific survival.
进行一项基于人群的分析，以描述前列腺特异性抗原（PSA）检测对诊断为前列腺癌的男性肿瘤学结局的影响。
我们使用监测、流行病学和最终结果-医疗保险关联数据，识别出1996年至2007年期间诊断为前列腺癌的98883名男性。我们将前列腺癌诊断前5年的PSA检测频率分为无、1至2次、3至5次和≥6次检测。我们使用倾向评分方法评估PSA检测频率对以下方面可能性的影响：（1）诊断时的转移情况，以及（2）总死亡率和前列腺癌特异性死亡率。
在调整分析中，PSA检测频率越高，被诊断为转移性前列腺癌的可能性越低（无检测，每100人年10.6例；1至2次检测，每100人年8.3例；3至5次检测，每100人年3.7例；≥6次检测，每100人年2.5例，P<0.001）。此外，PSA检测频率越高，总生存率和前列腺癌特异性生存率越高（两者P均<0.001）。
前列腺癌诊断前5年，70岁及以上男性进行更频繁的PSA检测，与被诊断为转移性前列腺癌的可能性降低以及总生存率和前列腺癌特异性生存率提高相关。
