Surveillance and Health Services Research, American Cancer Society, Atlanta, GA, USA.
J Natl Cancer Inst. 2021 Jan 4;113(1):64-71. doi: 10.1093/jnci/djaa068.
Previous studies reported that prostate cancer incidence rates in the United States declined for local-stage disease and increased for regional- and distant-stage disease following the US Preventive Services Task Force recommendations against prostate-specific antigen-based screening for men aged 75 years and older in 2008 and for all men in 2012. It is unknown, however, whether these patterns persisted through 2016.
Based on the US Cancer Statistics Public Use Research Database, we examined temporal trends in invasive prostate cancer incidence from 2005 to 2016 in men aged 50 years and older stratified by stage (local, regional, and distant), age group (50-74 years and 75 years and older), and race and ethnicity (all races and ethnicities, non-Hispanic Whites, and non-Hispanic Blacks) with joinpoint regression models to estimate annual percent changes. Tests of statistical significance are 2-sided (P < .05).
For all races and ethnicities combined, incidence for local-stage disease declined beginning in 2007 in men aged 50-74 years and 75 years and older, although the decline stabilized during 2013-2016 in men aged 75 years and older. Incidence decreased by 6.4% (95% CI = 4.9%-9% to 7.9%) per year from 2007 to 2016 in men aged 50-74 years and by 10.7% (95% CI = 6.2% to 15.0%) per year from 2007 to 2013 in men aged 75 years and older. In contrast, incidence for regional- and distant-stage disease increased in both age groups during the study period. For example, distant-stage incidence in men aged 75 years and older increased by 5.2% (95% CI = 4.2% to 6.1%) per year from 2010 to 2016.
Regional- and distant-stage prostate cancer incidence continue to increase in the United States in men aged 50 years and older, and future studies are needed to identify reasons for the rising trends.
此前的研究报告称,自 2008 年美国预防服务工作组建议 75 岁及以上男性和 2012 年所有男性避免基于前列腺特异性抗原的前列腺癌筛查以来,美国局部期前列腺癌的发病率下降,而区域性和远处期疾病的发病率上升。然而,目前尚不清楚这些模式是否持续到 2016 年。
基于美国癌症统计公共研究数据库,我们通过加入点回归模型,按阶段(局部、区域和远处)、年龄组(50-74 岁和 75 岁及以上)和种族和民族(所有种族和民族、非西班牙裔白人以及非西班牙裔黑人)对 2005 年至 2016 年 50 岁及以上男性的侵袭性前列腺癌发病率进行了时间趋势分析,以估计年度百分比变化。双侧检验具有统计学意义(P <.05)。
对于所有种族和民族,50-74 岁和 75 岁及以上男性的局部期疾病的发病率从 2007 年开始下降,尽管在 2013-2016 年,75 岁及以上男性的发病率趋于稳定。2007 年至 2016 年,50-74 岁男性的发病率每年下降 6.4%(95%CI=4.9%-9%至 7.9%),2007 年至 2013 年,75 岁及以上男性的发病率每年下降 10.7%(95%CI=6.2%至 15.0%)。相比之下,在整个研究期间,两个年龄组的区域性和远处期疾病的发病率均有所增加。例如,2010 年至 2016 年,75 岁及以上男性的远处期发病率每年增加 5.2%(95%CI=4.2%至 6.1%)。
美国 50 岁及以上男性的区域性和远处期前列腺癌发病率继续上升,需要进一步研究以确定上升趋势的原因。