Department of Urology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.
Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada.
Prostate. 2021 Sep;81(12):874-881. doi: 10.1002/pros.24184. Epub 2021 Jun 29.
Recently, an increase in the rates of high-risk prostate cancer (PCa) was reported. We tested whether the rates of and low, intermediate, high and very high-risk PCa changed over time. We also tested whether the number of prostate biopsy cores contributed to changes rates over time.
Within the Surveillance, Epidemiology and End Results (SEER) database (2010-2015), annual rates of low, intermediate, high-risk according to traditional National Comprehensive Cancer Network (NCCN) and high versus very high-risk PCa according to Johns Hopkins classification were tabulated without and with adjustment for the number of prostate biopsy cores.
In 119,574 eligible prostate cancer patients, the rates of NCCN low, intermediate, and high-risk PCa were, respectively, 29.7%, 47.8%, and 22.5%. Of high-risk patients, 39.6% and 60.4% fulfilled high and very high-risk criteria. Without adjustment for number of prostate biopsy cores, the estimated annual percentage changes (EAPC) for low, intermediate, high and very high-risk were respectively -5.5% (32.4%-24.9%, p < .01), +0.5% (47.6%-48.4%, p = .09), +4.1% (8.2%-9.9%, p < .01), and +8.9% (11.8%-16.9%, p < .01), between 2010 and 2015. After adjustment for number of prostate biopsy cores, differences in rates over time disappeared and ranged from 29.8%-29.7% for low risk, 47.9%-47.9% for intermediate risk, 8.9%-9.0% for high-risk, and 13.6%-13.6% for very high-risk PCa (all p > .05).
The rates of high and very high-risk PCa are strongly associated with the number of prostate biopsy cores, that in turn may be driven by broader use magnetic resonance imaging (MRI).
最近，高危前列腺癌（PCa）的发病率有所上升。我们检测了 PCa 的低危、中危、高危和极高危的发病率是否随时间变化而变化。我们还检测了前列腺活检核心数量是否会影响发病率随时间的变化。
在监测、流行病学和最终结果（SEER）数据库（2010-2015 年）中，根据传统的国家综合癌症网络（NCCN）和约翰霍普金斯分类，对低危、中危、高危和高危与极高危 PCa 的发病率进行了无和有前列腺活检核心数量调整的列表。
在 119574 名合格的前列腺癌患者中，NCCN 低危、中危和高危 PCa 的发病率分别为 29.7%、47.8%和 22.5%。高危患者中，39.6%和 60.4%符合高危和极高危标准。未调整前列腺活检核心数量时，低危、中危、高危和极高危的估计年百分比变化（EAPC）分别为-5.5%（32.4%-24.9%，p<0.01）、+0.5%（47.6%-48.4%，p=0.09）、+4.1%（8.2%-9.9%，p<0.01）和+8.9%（11.8%-16.9%，p<0.01），2010 年至 2015 年期间。调整前列腺活检核心数量后，随时间变化的发病率差异消失，低危风险为 29.8%-29.7%，中危风险为 47.9%-47.9%，高危风险为 8.9%-9.0%，极高危风险为 13.6%-13.6%（均 p>0.05）。
高危和极高危 PCa 的发病率与前列腺活检核心数量密切相关，而前列腺活检核心数量可能受更广泛使用磁共振成像（MRI）的驱动。
