2000年至2020年按Gleason评分的前列腺癌发病率和生存率趋势：意大利东北部的一项基于人群的研究。

Trends in Prostate Cancer Incidence and Survival by Gleason Score from 2000 to 2020: A Population-Based Study in Northeastern Italy.

作者信息

Taborelli Martina, Serraino Diego, Toffolutti Federica, Bidoli Ettore, De Vidi Sara, Fratino Lucia, Dal Maso Luigino

机构信息

Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy.

Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy.

出版信息

Curr Oncol. 2025 Jul 29;32(8):426. doi: 10.3390/curroncol32080426.

BACKGROUND

Prostate cancer (PCa) trends have evolved due to changing screening practices. This study assessed long-term trends in PCa incidence and survival according to Gleason score (GS) in Friuli Venezia Giulia, northeastern Italy.

METHODS

A population-based study was conducted, encompassing 21,571 PCa cases from the regional Cancer Registry, diagnosed between 2000 and 2020. Age-standardized incidence rates and 5-year overall (OS) and net survival (NS) were assessed by GS (2-6, 7, 8-10) and age group (<65, 65-74, ≥75). Trends were analyzed using Joinpoint regression.

RESULTS

PCa incidence increased from 2000 to 2007 (Annual Percent Change, APC = +1.8%), then declined sharply until 2010 (APC = -7.6%) and remained stable thereafter. Incidence of low-grade cancers (GS 2-6) decreased across all age groups, especially in men aged ≥ 75 years (APC = -8.1%). The incidence of GS 7 rose until 2007 and then stabilized. High-grade cancers (GS 8-10) showed a stable incidence, but their proportion increased from 20% to 29%, mainly in older men. Survival improved across all GS groups. For GS 2-6, OS increased from 81.4% to 88.2%; for GS 7, from 78.1% to 88.1%. GS 8-10 had smaller gains, but NS reached 82% in recent years. Among men aged ≥ 75 years, OS for GS 7 rose from 51.9% to 78.1%, and for GS 8-10, from 43.9% to 54.4%. NS remained high for GS ≤ 7.

CONCLUSIONS

While overall outcomes improved, the increasing proportion of high-grade PCa, despite a stable incidence, raises concerns, particularly in older men, and calls for tailored clinical strategies.

背景

由于筛查方式的改变，前列腺癌（PCa）的发病趋势有所演变。本研究评估了意大利东北部弗留利-威尼斯朱利亚地区前列腺癌发病率和生存率根据 Gleason 评分（GS）的长期趋势。

方法

开展了一项基于人群的研究，纳入了 2000 年至 2020 年间该地区癌症登记处诊断的 21571 例前列腺癌病例。按 GS（2 - 6、7、8 - 10）和年龄组（<65 岁、65 - 74 岁、≥75 岁）评估年龄标准化发病率以及 5 年总生存率（OS）和净生存率（NS）。使用 Joinpoint 回归分析趋势。

结果

前列腺癌发病率从 2000 年至 2007 年上升（年度百分比变化，APC = +1.8%），随后在 2010 年之前急剧下降（APC = -7.6%），此后保持稳定。所有年龄组中低级别癌症（GS 2 - 6）的发病率均下降，尤其是在≥75 岁的男性中（APC = -8.1%）。GS 7 的发病率在 2007 年之前上升，然后稳定下来。高级别癌症（GS 8 - 10）发病率稳定，但其比例从 20%增至 29%，主要在老年男性中。所有 GS 组的生存率均有所提高。对于 GS 2 - 6，OS 从 81.4%增至 88.2%；对于 GS 7，从 78.1%增至 88.1%。GS 8 - 10 的提升幅度较小，但近年来 NS 达到了 82%。在≥75 岁的男性中，GS 7 的 OS 从 51.9%升至 78.1%，GS 8 - 10 的 OS 从 43.9%升至 54.4%。GS≤7 的 NS 仍然很高。