Department of Urology, College of Medicine, Yeungnam University, Daegu, Korea.
Medical R&D Service Design Center, College of Medicine, Yeungnam University, Daegu, Korea.
Investig Clin Urol. 2022 Mar;63(2):184-191. doi: 10.4111/icu.20210463.
To document nationwide serum prostate-specific antigen (PSA) testing trends over the past decade and to investigate the impact of testing on prostate cancer (PCa) detection.
Using annual National Health Insurance Service of Korea data for the period 2006 to 2016, PSA testing rates were investigated for men aged ≥40 years by decade, and associations between test rates and registered PCa cases were analyzed.
During the study period, the incidence of PCa increased about threefold (4,415 in 2006 to 15,046 in 2016). PCa incidences increased with age (p<0.001) and about 60% of cases were over 70 years old. Despite a fourfold increase in PSA testing (246,911 in 2006 to 937,548 in 2016), the average exposure rate among all men was only 7.27% in 2016, and the mean number of repeat tests for those that did not develop PCa during the study period was 2.9. PSA test rates increased with age and in 2016 were 1.65% for those in their 40s, 4.90% for those in their 50s, 12.0% for those in their 60s, 19.2% for those in their 70s, and 21.6% for those aged ≥80. Regardless of the age groups, a significant association was found between PSA test numbers and the detection of PCas.
In contrast to the soaring incidence of PCa especially in those aged over 70 years who have a more frequent chance for PSA testing triggered by concomitant voiding symptoms, low exposure in general and among relatively younger men favors a countrywide screening policy.
记录过去十年全国范围内血清前列腺特异性抗原（PSA）检测趋势，并研究检测对前列腺癌（PCa）检出率的影响。
利用韩国国家健康保险服务 2006 年至 2016 年期间的年度数据，按十年为一个阶段，调查≥40 岁男性的 PSA 检测率，并分析检测率与登记 PCa 病例之间的关系。
在研究期间，PCa 的发病率增加了约三倍（2006 年为 4415 例，2016 年为 15046 例）。PCa 的发病率随年龄增长而增加（p<0.001），约 60%的病例年龄超过 70 岁。尽管 PSA 检测量增加了四倍（2006 年为 246911 次，2016 年为 937548 次），但 2016 年所有男性的平均暴露率仅为 7.27%，在研究期间未发生 PCa 的男性平均重复检测次数为 2.9 次。PSA 检测率随年龄增长而增加，2016 年 40 多岁人群的检测率为 1.65%，50 多岁人群的检测率为 4.90%，60 多岁人群的检测率为 12.0%，70 多岁人群的检测率为 19.2%，80 岁及以上人群的检测率为 21.6%。无论年龄组如何，PSA 检测次数与 PCa 的检出率均呈显著相关。
与 70 岁以上人群 PCa 发病率飙升形成鲜明对比的是，这些人群由于伴随排尿症状而更频繁地进行 PSA 检测，导致发病率升高，而总体上以及相对年轻男性中的低暴露率有利于全国范围内的筛查政策。
