Moody Thomas E, Spraitzar Curtis L, Eisenhart Elizabeth, Tully Scott
Urology Centers of AlabamaHomewood, AL.
Rev Urol. 2017;19(2):106-112. doi: 10.3909/riu0748.
To determine the impact of the American Urological Association's (AUA) guideline for early detection of prostate cancer that recommends against routine screening in men aged 40 to 54 years at average risk (eg, white men without a family history of prostate cancer), we undertook a study of 973 men who previously underwent a prostate biopsy at Urology Centers of Alabama (UCA) over the 5-year period from 2010 to 2014. We retrospectively reviewed the results of the prostate biopsies performed by urologists at UCA-and, where applicable, the final surgical pathology results and compared the results by race and family history. In white men with a family history of prostate cancer, 47% had cancer and 30% had Gleason score (GS) ≥ 7 disease. In white men without a family history of prostate cancer, 32% had cancer and 23% had GS ≥ 7 disease. By comparison, in African American men with a family history of prostate cancer, 56% had cancer and 42% had GS ≥ 7 disease. In African American men without a family history, 42% had cancer and 29% had GS ≥ 7 disease. In our study, 144 of 456 (32%) of the group of average-risk men had cancer and 105 of 456 (23%) had GS ≥ 7 cancer. Had the AUA guidelines been followed, these cancers would have been missed or the diagnoses delayed.
为确定美国泌尿外科学会（AUA）关于前列腺癌早期检测的指南的影响，该指南建议不应对平均风险的40至54岁男性（例如无前列腺癌家族史的白人男性）进行常规筛查，我们对973名男性进行了一项研究，这些男性在2010年至2014年的5年期间曾在阿拉巴马州泌尿学中心（UCA）接受前列腺活检。我们回顾性地审查了UCA泌尿科医生进行的前列腺活检结果，并在适用的情况下审查了最终手术病理结果，并按种族和家族史对结果进行了比较。在有前列腺癌家族史的白人男性中，47%患有癌症，30%的 Gleason评分（GS）≥7分。在无前列腺癌家族史的白人男性中，32%患有癌症，23%的GS≥7分。相比之下，在有前列腺癌家族史的非裔美国男性中，56%患有癌症，42%的GS≥7分。在无家族史的非裔美国男性中，42%患有癌症，29%的GS≥7分。在我们的研究中，456名平均风险男性中有144名（32%）患有癌症，456名中有105名（23%）患有GS≥7的癌症。如果遵循AUA指南，这些癌症将会被漏诊或诊断延迟。
