Olsson C A, Goluboff E T
Department of Urology, Squier Urologic Clinic, Columbia College of Physicians and Surgeons, Columbia Presbyterian Medical Center, New York, New York.
J Urol. 1994 Nov;152(5 Pt 2):1695-9. doi: 10.1016/s0022-5347(17)32364-9.
We examine changes in the detection and treatment of prostate cancer from the perspective of the urologist. There has been an extraordinary increase in the incidence of prostate cancer (60% from 1990 to 1993). We calculated, based on data from the literature and assumptions about changes in urological practice, that 52% of newly diagnosed cases would be treated by radical prostatectomy in 1993. Extrapolating from the work of Catalona, we derived the number of office consultations, prostate biopsies and orchiectomies associated with the diagnosis and treatment of these tumors. Applying Health Care Financing Administration reimbursements to our figures, we calculated that each urologist would realize $45,370 for prostate cancer care in the Medicare population in 1993. If all patients 50 to 70 years old were screened by American Cancer Society and American Urological Association recommended algorithms, this projection would be $107,919. Despite this enormous economic impact of prostate cancer on the urologist, uncertainties remain concerning the appropriateness of screening and treatment for this disease. Only increased funding for basic research in prostate cancer will resolve these uncertainties.
我们从泌尿科医生的角度审视前列腺癌检测与治疗方面的变化。前列腺癌发病率急剧上升（1990年至1993年增长了60%）。根据文献数据以及对泌尿科诊疗实践变化的假设，我们计算得出，1993年新诊断病例中有52%将接受根治性前列腺切除术。根据卡塔拉诺的研究成果进行推断，我们得出了与这些肿瘤的诊断和治疗相关的门诊会诊、前列腺活检及睾丸切除术的数量。将医疗保健财务管理局的报销费用应用于我们的数据，我们计算出，1993年每位泌尿科医生在医疗保险人群中治疗前列腺癌可获得45,370美元。如果按照美国癌症协会和美国泌尿外科学会推荐的算法对所有50至70岁的患者进行筛查，这一数字将为107,919美元。尽管前列腺癌给泌尿科医生带来了巨大的经济影响，但对于该疾病筛查和治疗的适宜性仍存在不确定性。只有增加对前列腺癌基础研究的资金投入，才能解决这些不确定性。
