Department of Urology, University of Washington Medical Center, Seattle, WA, USA.
Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
JNCI Cancer Spectr. 2020 Oct 26;5(1). doi: 10.1093/jncics/pkaa098. eCollection 2021 Feb.
Recent studies show decreasing prostate-specific antigen utilization and increasing incidence of metastatic prostate cancer in the United States after national recommendations against screening in 2012. Yet, whether the increasing incidence of metastatic prostate cancer is consistent in magnitude with the expected impact of decreased screening is unknown. We compared observed incidence of metastatic prostate cancer from the Surveillance, Epidemiology, and End Results program and published effects of continued historical screening and discontinued screening starting in 2013 projected by 2 models of disease natural history, screening, and diagnosis. The observed rate of new metastatic prostate cancer cases in 2017 was 44%-60% of the projected increase under discontinued screening relative to continued screening. Thus, the observed increase in incident metastatic prostate cancer is consistent with the expected impact of reduced screening. Although this comparison does not establish a causal relationship, it highlights the plausible role of decreased screening in the observed trend.
最近的研究表明，自 2012 年美国全国范围内建议停止筛查以来，前列腺特异性抗原的使用率下降，转移性前列腺癌的发病率上升。然而，尚不清楚转移性前列腺癌发病率的上升幅度是否与预期的筛查减少的影响相一致。我们比较了监测、流行病学和最终结果计划中观察到的转移性前列腺癌发病率，以及 2 种疾病自然史、筛查和诊断模型预测的从 2013 年开始继续和停止历史筛查的影响。与继续筛查相比，2017 年新发生的转移性前列腺癌病例的观察率在停止筛查预测的增加病例中占 44%-60%。因此，观察到的转移性前列腺癌发病率的上升与预期的筛查减少的影响相一致。尽管这种比较不能确定因果关系，但它突出了筛查减少在观察到的趋势中可能起的作用。
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