Imai K, Suzuki T, Yamanaka H, Nakata S, Tomaru Y, Sato J, Kato N
Department of Urology, Gunma University Medical School, Japan.
Urol Int. 1993;51(3):133-41. doi: 10.1159/000282531.
Since 1981 we have been studying prostate cancer (Pca) by mass screening (MS) in the Gunma Prefecture, Japan. From 1981 to 1990, 9,067 subjects (total 15,451) were examined in connection with this project and 121 subjects were diagnosed as having Pca. The presence of Pca in 87 cases was confirmed at their initial MS (initial group); 34 cases were confirmed either the year after or several years after the first MS (repeat group). To evaluate the significance of MS for Pca, in this group of patients, the effects of 'lead time bias', 'self-selection bias' and 'length bias' on the survival rate were compared to Pca patients detected in the hospitals of the Gunma Prefecture during the same period. The survival curves of MS cases for each stage of the disease were better than those of the controls. Only in stage D was there a significant difference between the two groups. However, this MS curve decreased from the 4th year in the same manner as the control curve from the start. The clinical characteristics (age, pathological differentiation, prostatic acid phosphatase, gait disturbance, erythrocyte sedimentation rate, chronic disease, and pain in the patients with stage D disease) were compared between both groups. All characteristics studied, except age, in the MS group were clinically more favorable compared to those of the controls for each stage or in total. Moreover, the relative survival rate of subjects examined by MS was greater than 1.0. No significant difference was found in stage distribution between the initial group and the repeat group.(ABSTRACT TRUNCATED AT 250 WORDS)
自1981年起，我们一直在日本群马县通过大规模筛查（MS）研究前列腺癌（Pca）。1981年至1990年，共有9067名受试者（总计15451人次）参与了该项目的检查，其中121名受试者被诊断患有Pca。87例患者在初次大规模筛查时确诊为Pca（初筛组）；34例在初次大规模筛查后的一年或数年后确诊（复筛组）。为评估大规模筛查对前列腺癌的意义，在这组患者中，将“领先时间偏倚”“自我选择偏倚”和“长度偏倚”对生存率的影响与同期在群马县医院确诊的前列腺癌患者进行了比较。各疾病阶段的大规模筛查病例的生存曲线均优于对照组。仅在D期，两组之间存在显著差异。然而，这条大规模筛查曲线从第4年开始以与对照组曲线相同的方式下降。比较了两组患者的临床特征（年龄、病理分化程度、前列腺酸性磷酸酶、步态障碍、红细胞沉降率、慢性病以及D期疾病患者的疼痛情况）。除年龄外，大规模筛查组所研究的所有特征在各阶段或总体上在临床上均比对照组更有利。此外，接受大规模筛查的受试者的相对生存率大于1.0。初筛组和复筛组在分期分布上未发现显著差异。（摘要截选至250字）
