Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Section of Urology, Department of Surgery, University of Chicago, Chicago, IL, USA.
Prostate Cancer Prostatic Dis. 2016 Dec;19(4):395-397. doi: 10.1038/pcan.2016.30. Epub 2016 Jul 19.
Changes in prostate cancer screening practices in the United States have led to recent declines in overall incidence, but it is unknown whether relaxed screening has led to changes in the incidence of advanced and metastatic prostate cancer at diagnosis.
We identified all men diagnosed with prostate cancer in the National Cancer Data Base (2004-2013) at 1089 different health-care facilities in the United States. Joinpoint regressions were used to model annual percentage changes (APCs) in the incidence of prostate cancer based on stage relative to that of 2004.
The annual incidence of metastatic prostate cancer increased from 2007 to 2013 (Joinpoint regression: APC: 7.1%, P<0.05) and in 2013 was 72% more than that of 2004. The incidence of low-risk prostate cancer decreased from years 2007 to 2013 (APC: -9.3%, P<0.05) to 37% less than that of 2004. The greatest increase in metastatic prostate cancer was seen in men aged 55-69 years (92% increase from 2004 to 2013).
Beginning in 2007, the incidence of metastatic prostate cancer has increased especially among men in the age group thought most likely to benefit from definitive treatment for prostate cancer. These data highlight the continued need for nationwide refinements in prostate cancer screening and treatment.
美国前列腺癌筛查实践的改变导致了整体发病率的近期下降，但尚不清楚放松筛查是否导致了诊断时晚期和转移性前列腺癌发病率的变化。
我们在美国 1089 家不同医疗保健机构的国家癌症数据库（2004-2013 年）中确定了所有被诊断为前列腺癌的男性。使用 Joinpoint 回归模型根据与 2004 年相比的阶段来对前列腺癌发病率的年百分比变化（APC）进行建模。
转移性前列腺癌的年发病率从 2007 年增加到 2013 年（Joinpoint 回归：APC：7.1%，P<0.05），2013 年比 2004 年增加了 72%。低危前列腺癌的发病率从 2007 年到 2013 年（APC：-9.3%，P<0.05）下降到比 2004 年减少了 37%。转移性前列腺癌的最大增加见于 55-69 岁的男性（与 2004 年相比增加了 92%）。
自 2007 年以来，转移性前列腺癌的发病率一直在增加，尤其是在最有可能从前列腺癌确定性治疗中受益的年龄组的男性中。这些数据强调了在全国范围内进一步改进前列腺癌筛查和治疗的持续需求。
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