Akaza Hideyuki, Onozawa Mizuki, Hinotsu Shiro
Strategic Investigation on Comprehensive Cancer Network, Interfaculty Initiative in Information Studies, Graduate School of Interdisciplinary Information Studies, The University of Tokyo, Tokyo, Japan.
Department of Urology, Tokyo-Kita Medical Center, Tokyo, Japan.
World J Urol. 2017 Jun;35(6):859-865. doi: 10.1007/s00345-016-1939-7. Epub 2016 Sep 19.
Differences in the incidence and mortality rates for prostate cancer between East and West are clearly defined, with higher rates in the West and lower rates in the East. Treatment methods are generally selected in accordance with general practice guidelines, but the current reality in Asia is that there is not sufficient clinical data to set Asia-specific guidelines for treatment. This leads to a situation whereby for the large part guidelines based on scientific evidence accumulated in Western countries are followed, but from time to time cases are encountered when such guidelines may not be considered to be the most appropriate for the case at hand.
Although there is a relatively large volume of clinical evidence relating to endocrine therapy in Asia, the treatment choices and effects differ to those in the West. These regional differences are thought to be due to various factors, including not only differences in genetic background, but also distinct differences in the living and healthcare environments. If the differences between East and West in terms of trends in prostate cancer could be examined, with positive aspects being adopted and negative aspects being improved, this could also be expected to be of use in developing a better treatment strategy for prostate cancer. The exchanging of information on a broader, global level will enable improvements in prevention, diagnosis and treatment of prostate cancer.
It is in pursuit of this objective that it is important to promote high-quality clinical trials and joint epidemiological studies in Asia and work to accumulate data that are comparable to data available in Western countries.
东西方前列腺癌的发病率和死亡率差异明显，西方发病率较高，东方发病率较低。治疗方法通常根据一般实践指南选择，但亚洲目前的实际情况是，没有足够的临床数据来制定针对亚洲的治疗指南。这导致在很大程度上遵循基于西方国家积累的科学证据的指南，但有时会遇到这些指南可能不被认为最适合手头病例的情况。
尽管亚洲有相对大量关于内分泌治疗的临床证据，但治疗选择和效果与西方不同。这些地区差异被认为是由多种因素造成的，不仅包括遗传背景的差异，还包括生活和医疗环境的明显差异。如果能够研究东西方在前列腺癌趋势方面的差异，吸取积极方面并改进消极方面，这有望为制定更好的前列腺癌治疗策略提供帮助。在更广泛的全球层面交流信息将有助于改善前列腺癌的预防、诊断和治疗。
正是为了追求这一目标，在亚洲推动高质量的临床试验和联合流行病学研究，并努力积累与西方国家可比的数据非常重要。
