南非自由州黑人男性前列腺癌患者的特征。
The profile of Black South African men diagnosed with prostate cancer in the Free State, South Africa.
机构信息
Department of Family Medicine, Faculty of Health Sciences, School of Clinical Medicine, University of the Free State, Bloemfontein.
出版信息
S Afr Fam Pract (2004). 2023 Jan 10;65(1):e1-e10. doi: 10.4102/safp.v65i1.5553.
BACKGROUND
Prostate cancer (PCa) ranks high in terms of morbidity and mortality, especially in Africa. Prostate-specific antigen (PSA) screening remains a practical method of screening for and thereby detecting PCa early, especially among African men who are more negatively affected. Modifiable risk factors for PCa are mostly behavioural and lifestyle. Understanding community-specific determinants is important when developing health promotion interventions.
OBJECTIVE
This study aimed to determine the profile of African men with PCa in the Free State, South Africa.
METHOD
A cross-sectional descriptive study was conducted using case record information and self-administered questionnaires among 341 African men with PCa attending the oncology and urology clinics of a tertiary hospital.
RESULT
Participants' median age at diagnosis was 66 years. Only 76 (22.3%) participants had ever heard of PCa prior to being diagnosed with the disease, 36 (47.4%) of whom had ever had screening performed. The majority (n = 298, 87.4%) were symptomatic; 50% sought medical help within six months. At diagnosis, 133 (39.0%) men presented with stage T3 or T4 disease, 75 (22.0%) with metastatic disease and 84 (24.6%) with Gleason score ≥ 8. Factors associated with advanced and high-grade disease included smoking, decreased sunlight exposure and physical activity, relatively increased ingestion of dairy products and red meat. Factors associated with early stage and low-grade disease included relatively increased ingestion of fruits, vegetables and fish.
CONCLUSION
Advanced and high-grade PCa disease is not uncommon among men ≥ 60 years in this study setting. Certain modifiable risk factors associated with advanced disease were established in this study. The majority had lower urinary tract symptoms (LUTS) prior to PCa diagnosis, but they were of poor health-seeking behaviour. Although there seems not to be a systematic delay in the definitive diagnosis and initiation of treatment for PCa, there is a need to improve on health education and awareness in the study setting.
背景
前列腺癌（PCa）在发病率和死亡率方面都很高，尤其是在非洲。前列腺特异性抗原（PSA）筛查仍然是早期发现 PCa 的实用方法，特别是在受影响更大的非洲男性中。PCa 的可改变风险因素主要是行为和生活方式。在制定健康促进干预措施时，了解特定社区的决定因素很重要。
目的
本研究旨在确定南非自由州患有 PCa 的非洲男性的特征。
方法
使用病例记录信息和 341 名在一家三级医院的肿瘤学和泌尿科诊所就诊的非洲男性 PCa 患者的自我管理问卷，进行了一项横断面描述性研究。
结果
参与者的中位诊断年龄为 66 岁。仅有 76 名（22.3%）参与者在被诊断患有该疾病之前听说过 PCa，其中 36 名（47.4%）曾接受过筛查。大多数（n=298，87.4%）有症状；50%的人在六个月内寻求医疗帮助。在诊断时，133 名（39.0%）男性患有 T3 或 T4 期疾病，75 名（22.0%）患有转移性疾病，84 名（24.6%）患有 Gleason 评分≥8。与晚期和高级别疾病相关的因素包括吸烟、减少阳光照射和体育活动、相对增加乳制品和红色肉类的摄入。与早期和低级别疾病相关的因素包括相对增加水果、蔬菜和鱼类的摄入。
结论
在本研究环境中，60 岁以上男性中晚期和高级别 PCa 并不罕见。本研究确定了与晚期疾病相关的某些可改变风险因素。大多数患者在被诊断为 PCa 之前有下尿路症状（LUTS），但他们的健康寻求行为不佳。尽管 PCa 的明确诊断和治疗似乎没有系统延迟，但仍需要改善研究环境中的健康教育和意识。
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