Department of Therapeutic Radiology, Yale School of Medicine, New Haven, CT, USA.
Department of Urology, New York University School of Medicine, NY, USA.
Cancer Control. 2020 Jan-Dec;27(1):1073274820902267. doi: 10.1177/1073274820902267.
Decreased prostate-specific antigen screening since 2008 has generated much concern, including report of recent increase in metastatic prostate cancer incidence among older men. Although increased metastatic disease was temporally proceeded by decreased screening and decreased localized prostate cancer at diagnosis, it is unclear whether the 2 trends are geographically connected. We therefore used the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) database to assess geographic-specific associations between changes in localized (2008-2011) and later changes in metastatic prostate cancer incidence (2012-2015). We examined trends from 200 health-care service areas (HSAs) within SEER 18 registries. While on average for each HSA, localized incidence decreased by 27.4 and metastatic incidence increased by 2.3 per 100 000 men per year, individual HSA-level changes in localized incidence did not correlate with later changes in metastatic disease. Decreased detection of localized disease may not fully explain the recent increase in metastatic disease at diagnosis.
自 2008 年以来，前列腺特异性抗原筛查的减少引起了广泛关注，包括最近报告称老年男性转移性前列腺癌的发病率有所增加。虽然在诊断时局部前列腺癌的检出率下降和转移性疾病的增加存在时间上的先后关系，但这两个趋势在地域上是否存在关联尚不清楚。因此，我们利用美国国家癌症研究所的监测、流行病学和最终结果（SEER）数据库，评估了局部前列腺癌发病率（2008-2011 年）和随后转移性前列腺癌发病率（2012-2015 年）变化之间的地域特异性关联。我们对 SEER18 个登记处的 200 个卫生保健服务区域（HSA）的趋势进行了检查。尽管平均而言，每个 HSA 的局部发病率每年每 10 万男性下降 27.4，转移性发病率每年每 10 万男性上升 2.3，但局部发病率的个体 HSA 水平变化与转移性疾病的后期变化没有相关性。局部疾病检出率的下降可能并不能完全解释诊断时转移性疾病的近期增加。
