Department of Health Policy and Management, Emory University, Atlanta, GA.
Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA.
Urol Oncol. 2021 Jul;39(7):432.e1-432.e10. doi: 10.1016/j.urolonc.2020.11.024. Epub 2020 Dec 9.
The treatment for men diagnosed with localized prostate cancer has changed over time given the increased attention to the harms associated with over-diagnosis and the development of protocols for active surveillance.
We examined trends in the treatment of men diagnosed with localized prostate cancer between 2004 and 2015, using the most recently available data from Surveillance, Epidemiology, and End Results Program (SEER)-Medicare. Patients were stratified by Gleason score, age, and race groups.
The use of active surveillance increased from 22% in 2004-2005 to 50% in 2014-2015 for patients with a Gleason score of 6 or below and increased from 9% in 2004-2005 to 13% in 2014-2015 for patients with a Gleason score of 7 or above. Patients with a Gleason score of 7 or above had increased use of intensity-modulated radiation therapy and prostatectomy, especially among patients aged 75 years and older. Among patients with a Gleason score of 6 or below non-Hispanic black men were less likely to undergo active surveillance than non-Hispanic white men.
There has been a large increase in the use of active surveillance among men with a Gleason score of 6 or below. However, non-Hispanic black men with a Gleason score of 6 or below are less likely to receive active surveillance.
由于过度诊断相关危害以及主动监测方案的制定受到越来越多的关注，男性局限性前列腺癌的治疗方法随时间发生了变化。
我们利用最近来自监测、流行病学和最终结果计划（SEER）-医疗保险的可用数据，研究了 2004 年至 2015 年间男性局限性前列腺癌治疗方法的变化趋势。按照 Gleason 评分、年龄和种族对患者进行分层。
对于 Gleason 评分为 6 或以下的患者，主动监测的使用率从 2004-2005 年的 22%增加到 2014-2015 年的 50%；对于 Gleason 评分为 7 或以上的患者，其使用率从 2004-2005 年的 9%增加到 2014-2015 年的 13%。Gleason 评分 7 或以上的患者增加了强度调制放射治疗和前列腺切除术的应用，尤其是在 75 岁及以上的患者中。Gleason 评分 6 或以下的患者中，非西班牙裔黑人接受主动监测的可能性低于非西班牙裔白人。
Gleason 评分 6 或以下的男性中，主动监测的应用有了大幅增加。然而，Gleason 评分 6 或以下的非西班牙裔黑人接受主动监测的可能性较低。
