Lin Po-Hung, Chang Su-Wei, Tsai Ling-Hsuan, Kan Hung-Cheng, Liu Jui-Ming, Chuang Cheng-Keng, Pang See-Tong, Yu Kai-Jie
Division of Urology, Department of Surgery, Chang Gung Memorial Hospital at Linkou.
Graduate Institute of Clinical Medical Science, College of Medicine.
Medicine (Baltimore). 2020 Sep 25;99(39):e22336. doi: 10.1097/MD.0000000000022336.
Over the past decades, the incidence of prostate cancer in Taiwan kept rising. Many possible factors including the utility of prostate specific antigen tests, lifestyle remodeling, and patient's comorbidities may contribute to the increasing of incidence or prostate cancer. We aim to use the nationwide Health and Welfare Database (HWD) to investigate possible associated factors.We used HWD, a nationwide database of medical information, to assess the incidence of prostate cancer, utilization of prostate-specific antigen (PSA) test, and underlying diseases of patients and to evaluate whether there was a common trend among these factors.In total, 32,508 patients with newly diagnosed prostate cancer from 2006 to 2013 were identified. The incidence rate of prostate cancer per 100,000 men increased from 35.47 in 2006 to 52.87 in 2012. The number of patients with prostate cancer and underlying diseases related to metabolic syndrome increased every year. The number of total PSA tests and patients undergoing PSA testing, as well as average times of PSA testing per person in the whole population, increased every year. The average PSA test times of patients with newly diagnosed prostate cancer within 3 years before the diagnosis of prostate cancer also increased every year. There was a high correlation between the average PSA test times and the number of patients with newly diagnosed prostate cancer (r = 0.9734).The trends of incidence of prostate cancer, utilization of PSA testing, and underlying diseases related to metabolic syndrome at the diagnoses of cancer were similar, increasing every year in the study period. The results suggested that increasing use of PSA tests may increase the diagnosis of prostate cancers. Underlying diseases related to metabolic syndrome might also affect the incidence of prostate cancer.
在过去几十年里，台湾地区前列腺癌的发病率持续上升。许多可能的因素，包括前列腺特异性抗原检测的应用、生活方式的改变以及患者的合并症，都可能导致前列腺癌发病率的增加。我们旨在利用全国性的健康与福利数据库（HWD）来调查可能的相关因素。我们使用HWD（一个全国性的医疗信息数据库）来评估前列腺癌的发病率、前列腺特异性抗原（PSA）检测的使用情况以及患者的基础疾病，并评估这些因素之间是否存在共同趋势。总共确定了2006年至2013年期间32,508例新诊断的前列腺癌患者。每10万名男性中前列腺癌的发病率从2006年的35.47上升至2012年的52.87。前列腺癌患者以及与代谢综合征相关的基础疾病患者数量每年都在增加。总体PSA检测次数、接受PSA检测的患者数量以及整个人口中每人的平均PSA检测次数每年都在增加。在前列腺癌诊断前3年内新诊断的前列腺癌患者的平均PSA检测次数也每年都在增加。平均PSA检测次数与新诊断的前列腺癌患者数量之间存在高度相关性（r = 0.9734）。在研究期间，前列腺癌发病率、PSA检测的使用情况以及癌症诊断时与代谢综合征相关的基础疾病的趋势相似，每年都在增加。结果表明，PSA检测使用的增加可能会增加前列腺癌的诊断。与代谢综合征相关的基础疾病也可能影响前列腺癌的发病率。
