晚期前列腺癌患者的 5 年生存率：军事卫生系统与美国普通人群的比较。
Five-year survival of patients with late-stage prostate cancer: comparison of the Military Health System and the U.S. general population.
机构信息
Murtha Cancer Center/Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
出版信息
Br J Cancer. 2023 Apr;128(6):1070-1076. doi: 10.1038/s41416-022-02136-3. Epub 2023 Jan 6.
BACKGROUND
While the 5-year survival rate for local and regional prostate cancer is nearly 100%, it decreases dramatically for advanced tumours. Accessibility to health care is an important factor for cancer prognosis. The U.S. Military Health System (MHS) provides universal health care to its beneficiaries, reducing financial barriers to medical care. However, whether the universal care translates into improved survival among patients with advanced prostate cancer in the MHS is unknown. In this study, we compared the MHS and the U.S. general population in survival of patients with advanced prostate cancer (stages III and IV).
METHODS
The MHS patients (N = 5379) were identified from the Department of Defense's (DoD) Automated Central Tumor Registry (ACTUR). Patients in the U.S. general population (N = 21,516) were identified from the Surveillance, Epidemiology, and End Results (SEER) programme. The two populations were matched on age, race, and diagnosis year.
RESULTS
The ACTUR patients exhibited longer 5-year survival than the matched SEER patients (HR = 0.74, 95% CI = 0.67-0.83), after adjustment for the potential confounders. The improved survival was observed for ages 50 years or older, both White patients and Black patients, all tumour stages and grades. This was also demonstrated despite the receipt of surgery or radiation treatment.
CONCLUSIONS
MHS beneficiaries with advanced prostate cancer had longer survival than their counterparts in the U.S. general population.
背景
尽管局部和区域性前列腺癌的 5 年生存率接近 100%，但对于晚期肿瘤，这一数字会大幅下降。获得医疗保健是癌症预后的一个重要因素。美国军事医疗系统（MHS）为其受益人提供全民医疗保健，减少了医疗保健的经济障碍。然而，MHS 中晚期前列腺癌患者的全民医疗保健是否转化为生存改善尚不清楚。在这项研究中，我们比较了 MHS 和美国一般人群中晚期前列腺癌（III 期和 IV 期）患者的生存率。
方法
MHS 患者（N=5379）从国防部的自动中央肿瘤登记处（ACTUR）中确定。美国一般人群中的患者（N=21516）从监测、流行病学和最终结果（SEER）计划中确定。这两个群体在年龄、种族和诊断年份上进行匹配。
结果
调整潜在混杂因素后，ACTUR 患者的 5 年生存率高于匹配的 SEER 患者（HR=0.74，95%CI=0.67-0.83）。这一改善的生存情况在 50 岁及以上、白人和黑人患者、所有肿瘤分期和分级中都观察到。尽管接受了手术或放疗治疗，也观察到了这种情况。
结论
MHS 中晚期前列腺癌受益人的生存率高于美国一般人群中的对应人群。
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