2022 年前列腺癌流行病学和风险因素的更新:系统评价。
2022 Update on Prostate Cancer Epidemiology and Risk Factors-A Systematic Review.
机构信息
Department of Surgery (Urology Service), Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
Department of Surgery (Urology Service), Memorial Sloan Kettering Cancer Center, New York, NY, USA.
出版信息
Eur Urol. 2023 Aug;84(2):191-206. doi: 10.1016/j.eururo.2023.04.021. Epub 2023 May 16.
CONTEXT
Prostate cancer (PCa) is one of the most common cancers worldwide. Understanding the epidemiology and risk factors of the disease is paramount to improve primary and secondary prevention strategies.
OBJECTIVE
To systematically review and summarize the current evidence on the descriptive epidemiology, large screening studies, diagnostic techniques, and risk factors of PCa.
EVIDENCE ACQUISITION
PCa incidence and mortality rates for 2020 were obtained from the GLOBOCAN database of the International Agency for Research on Cancer. A systematic search was performed in July 2022 using PubMed/MEDLINE and EMBASE biomedical databases. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines and was registered in PROSPERO (CRD42022359728).
EVIDENCE SYNTHESIS
Globally, PCa is the second most common cancer, with the highest incidence in North and South America, Europe, Australia, and the Caribbean. Risk factors include age, family history, and genetic predisposition. Additional factors may include smoking, diet, physical activity, specific medications, and occupational factors. As PCa screening has become more accepted, newer approaches such as magnetic resonance imaging (MRI) and biomarkers have been implemented to identify patients who are likely to harbor significant tumors. Limitations of this review include the evidence being derived from meta-analyses of mostly retrospective studies.
CONCLUSIONS
PCa remains the second most common cancer among men worldwide. PCa screening is gaining acceptance and will likely reduce PCa mortality at the cost of overdiagnosis and overtreatment. Increasing use of MRI and biomarkers for the detection of PCa may mitigate some of the negative consequences of screening.
PATIENT SUMMARY
Prostate cancer (PCa) remains the second most common cancer among men, and screening for PCa is likely to increase in the future. Improved diagnostic techniques can help reduce the number of men who need to be diagnosed and treated to save one life. Avoidable risk factors for PCa may include factors such as smoking, diet, physical activity, specific medications, and certain occupations.
背景
前列腺癌(PCa)是全球最常见的癌症之一。了解疾病的流行病学和风险因素对于改善初级和二级预防策略至关重要。
目的
系统回顾和总结 PCa 的描述性流行病学、大型筛查研究、诊断技术和风险因素的现有证据。
证据获取
从国际癌症研究机构(IARC)的 GLOBOCAN 数据库获取 2020 年 PCa 的发病率和死亡率数据。2022 年 7 月,使用 PubMed/MEDLINE 和 EMBASE 生物医学数据库进行了系统搜索。本综述按照系统评价和荟萃分析的首选报告项目(PRISMA)指南进行,并在 PROSPERO(CRD42022359728)中进行了注册。
证据综合
在全球范围内,PCa 是第二常见的癌症,在北美、南美、欧洲、澳大利亚和加勒比地区发病率最高。风险因素包括年龄、家族史和遗传易感性。其他因素可能包括吸烟、饮食、体育活动、特定药物和职业因素。随着 PCa 筛查的接受程度提高,新的方法如磁共振成像(MRI)和生物标志物已被用于识别可能存在显著肿瘤的患者。本综述的局限性包括证据主要来自回顾性研究的荟萃分析。
结论
PCa 仍然是全球男性中第二常见的癌症。PCa 筛查的接受程度正在提高,这可能会降低 PCa 的死亡率,但代价是过度诊断和过度治疗。MRI 和生物标志物在 PCa 检测中的广泛应用可能会减轻筛查的一些负面影响。
患者总结
前列腺癌(PCa)仍然是男性中第二常见的癌症,未来 PCa 的筛查可能会增加。改进的诊断技术可以帮助减少需要诊断和治疗以挽救生命的男性数量。可避免的 PCa 风险因素可能包括吸烟、饮食、体育活动、特定药物和某些职业等因素。