Threlfall T J, English D R, Rouse I L
Health Department of Western Australia, East Perth.
Med J Aust. 1998 Jul 6;169(1):21-4. doi: 10.5694/j.1326-5377.1998.tb141472.x.
To measure trends in recorded incidence and mortality rates of prostate cancer in Western Australia from 1985 to 1996 and to relate these to prostate-specific antigen (PSA) testing for prostate cancer.
Descriptive study based on data from the Western Australian Cancer Registry, the Australian Bureau of Statistics and the Health Insurance Commission.
All newly diagnosed cases of prostate cancer and all deaths from prostate cancer in Western Australia from 1985 to 1996.
Recorded incidences and mortality rates for prostate cancer.
After increasing steadily from 42 per 100,000 person-years in 1985 to 61 in 1992, the recorded incidence more than doubled to 134 per 100,000 person-years in 1994, then fell sharply to 87 in 1996. Among men aged 50 years or more, those aged 50-54 years had the largest annual increases: 14% (95% confidence interval [CI], 10%-19%) from 1985 to 1992 and 108% (95% CI, 84%-134%) from 1992 to 1994. They also had the smallest annual decline between 1994 and 1996 (8%; 95% CI, 1% increase to 16% decrease). The mortality rate showed no sudden increases or decreases. In men aged 60 years or older, the mortality rate increased annually by 2.9% (95% CI, 2%-4%) from 1985 to 1996. The number of Medicare reimbursements for PSA tests increased until May 1995, then fell. There was a significant correlation between the monthly number of PSA tests and new cases of prostate cancer (P < 0.01).
Following a period of steady increase, the recorded incidence of prostate cancer increased dramatically in 1992 because of screening by PSA testing. From 1994, these incidence figures declined almost as sharply, partly because of reductions in testing. The mortality rate has not shown any systematic deviation from its long-term trend.
测定1985年至1996年西澳大利亚州前列腺癌记录发病率和死亡率的变化趋势，并将这些变化与前列腺癌的前列腺特异性抗原（PSA）检测联系起来。
基于西澳大利亚癌症登记处、澳大利亚统计局和健康保险委员会数据的描述性研究。
1985年至1996年西澳大利亚州所有新诊断的前列腺癌病例和所有前列腺癌死亡病例。
前列腺癌记录发病率和死亡率。
记录发病率从1985年的每10万人年42例稳步上升至1992年的每10万人年61例，1994年增至每10万人年134例，增长了一倍多，随后在1996年急剧降至每10万人年87例。在50岁及以上男性中，50 - 54岁年龄组的年增幅最大：1985年至1992年为14%（95%置信区间[CI]，10% - 19%），1992年至1994年为108%（95% CI，84% - 134%）。他们在1994年至1996年期间的年降幅也最小（8%；95% CI，增加1%至下降16%）。死亡率没有突然上升或下降。在60岁及以上男性中，1985年至1996年死亡率每年上升2.9%（95% CI，2% - 4%）。医疗保险对PSA检测的报销次数在1995年5月前增加，之后下降。PSA检测月次数与前列腺癌新病例数之间存在显著相关性（P < 0.01）。
经过一段时间的稳步上升后，由于PSA检测筛查，1992年前列腺癌记录发病率急剧上升。从1994年起，这些发病率数字下降几乎同样急剧，部分原因是检测减少。死亡率未显示出与其长期趋势有任何系统性偏差。
