Kimura Takahiro, Sato Shun, Takahashi Hiroyuki, Egawa Shin
Department of Urology, The Jikei University School of Medicine, Tokyo 105-8461, Japan.
Department of Pathology, The Jikei University School of Medicine, Tokyo 105-8461, Japan.
Cancers (Basel). 2021 Jan 19;13(2):359. doi: 10.3390/cancers13020359.
The incidence of prostate cancer (PC) has been increasing in Asian countries, where it was previously low. Although the adoption of a Westernized lifestyle is a possible explanation, the incidence is statistically biased due to the increase in prostate-specific antigen (PSA) screening and the accuracy of national cancer registration systems. Studies on latent PC provide less biased information. This review included studies evaluating latent PC in several countries after excluding studies using random or single-section evaluations and those that did not mention section thickness. The findings showed that latent PC prevalence has been stable since 1950 in Western countries, but has increased over time in Asian countries. Latent PC in Asian men has increased in both prevalence and number of high-grade cases. Racial differences between Caucasian and Asian men may explain the tumor location of latent PC. In conclusion, the recent increase in latent PC in Asian men is consistent with an increase in clinical PC. Evidence suggests that this increase is caused not only by the increase in PSA screening, but also by the adoption of a more Westernized lifestyle. Autopsy findings suggest the need to reconsider the definition of clinically insignificant PC.
前列腺癌（PC）在亚洲国家的发病率一直在上升，而这些国家之前的发病率较低。尽管采用西化的生活方式可能是一个解释，但由于前列腺特异性抗原（PSA）筛查的增加以及国家癌症登记系统的准确性，发病率在统计上存在偏差。关于潜伏性PC的研究提供的偏差信息较少。本综述纳入了在排除使用随机或单切片评估的研究以及未提及切片厚度的研究后，对几个国家潜伏性PC进行评估的研究。研究结果表明，自1950年以来，西方国家潜伏性PC的患病率一直稳定，但在亚洲国家却随时间增加。亚洲男性潜伏性PC的患病率和高级别病例数均有所增加。白种人和亚洲男性之间的种族差异可能解释了潜伏性PC的肿瘤位置。总之，亚洲男性近期潜伏性PC的增加与临床PC的增加是一致的。有证据表明，这种增加不仅是由PSA筛查的增加引起的，也是由采用更西化的生活方式引起的。尸检结果表明有必要重新考虑临床意义不显著的PC的定义。
