Ishkinin Yevgeniy, Zhylkaidarova Alma, Nurgaliyev Nurzhan, Auyezova Elmira, Oshibayeva Ainash, Gorbunova Nadezhda
Kazakh Institute of Oncology and Radiology, Almaty, Kazakhstan.
Medical University "High School of Public Health", Almaty, Kazakhstan.
Iran J Public Health. 2017 Jul;46(7):917-922.
Issues of mass screening for prostate cancer rather controversial since 2013 in 11 regions of Kazakhstan introduced a population-based screening for prostate cancer, so we need to evaluate its results.
In different regions of Kazakhstan during 2013-2015, a total of 321548 prostate-specific antigens (PSA) were determined in men aged 50-66 yr, under the Prostate Health Index (PHI) and transrectal ultrasonography (TRUS) guided prostate biopsy with histological examination.
PSA level up to 4 ng/ml in 310870 (96.7%) men, PSA level between 4 and 10 ng/ml in 8 624 (2.7%) men, PSA level above 10 ng/ml in 2054 (0.6%) men. PHI was identified in 5716 (1.8%) men, of which 2867 cases were with PHI ≥ 25 (35.9%). Totally, 3680 biopsies (1.1%) of the prostate were performed. As part of the screening, 2870 cases (0.88%) of benign prostatic hyperplasia and prostatic intraepithelial neoplasia were found. Of 742 cases of prostate cancer (0.23%) were revealed. The stages of prostate cancer screening were as follows: stage I in 172 men (23.2%), stage II in 444 men (59.8%), stage III in 98 men (13.2%) and stage IV in 28 (3.8%) men. The indicators of prostate cancer early diagnosis in the I-II stages were bigger in the "screening regions" than in the "traditional diagnostics" regions: RR 1.35 95% CI (1.24 - 1.46), OR 1.84 95% CI (1.58-2.15). Prostate cancer was detected at I-II stages in the "screening" regions only by screening vs traditional diagnostics, with RR 1.64 95% CI (1.56 - 1.73), OR 4.77 95% CI (3.87-5.87).
Implementation of screening can improve the diagnosis of prostate cancer in the early stages.
自2013年起，哈萨克斯坦11个地区开展了基于人群的前列腺癌筛查，该筛查问题颇具争议，因此我们需要评估其结果。
2013年至2015年期间，在哈萨克斯坦不同地区，对50至66岁男性共检测了321548次前列腺特异性抗原（PSA），并在前列腺健康指数（PHI）和经直肠超声（TRUS）引导下进行前列腺活检及组织学检查。
310870名（96.7%）男性的PSA水平高达4 ng/ml，8624名（2.7%）男性的PSA水平在4至10 ng/ml之间，2054名（0.6%）男性的PSA水平高于10 ng/ml。5716名（1.8%）男性检测出PHI，其中2867例PHI≥25（35.9%）。共进行了3680例（1.1%）前列腺活检。作为筛查的一部分，发现2870例（0.88%）良性前列腺增生和前列腺上皮内瘤变。共发现742例前列腺癌（0.23%）。前列腺癌筛查分期如下：I期172例（23.2%），II期444例（59.8%），III期98例（13.2%），IV期28例（3.8%）。“筛查地区”前列腺癌I-II期的早期诊断指标高于“传统诊断”地区：相对危险度1.35，95%可信区间（1.24 - 1.46），比值比1.84，95%可信区间（1.58 - 2.15）。仅通过筛查在“筛查”地区I-II期检测出前列腺癌，而传统诊断未检测出，相对危险度1.64，95%可信区间（1.56 - 1.73），比值比4.77，95%可信区间（(3.87 - 5.87）。
实施筛查可改善前列腺癌的早期诊断。
