在预期寿命有限的老年男性中进行PSA查
Louise C Walter1, Daniel Bertenthal, Karla Lindquist
1Division of Geriatrics, San Francisco VA Medical Center, California, San Francisco 94121, USA. louise.walter@ucsf.edu
JAMA
|November 16, 2006
概括
前列腺特异性抗原 (PSA) 查在老年男性中很常见,即使是那些预期寿命有限的人. 目前针对老年男性,特别是退伍军人的查实践没有充分考虑预后,导致潜在的伤害.
科学领域:
- 老年医学 老年医学
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 公共卫生 公共卫生
背景情况:
- 准则通常不鼓励老年男性进行前列腺特异性抗原 (PSA) 查,因为潜在的危害超过了益处.
- 关于老年男性相对于他们的预期寿命的实际PSA查实践的有限大规模数据存在.
研究的目的:
- 评估老年男性中PSA查的患病率,特别是包括那些预期寿命有限的人.
- 针对老年退伍军人的年龄和健康状况,描述PSA查模式.
主要方法:
- 一项队列研究分析了597,642名70岁以上的男性退伍军人,来自美国退伍军人事务部的104个设施 (2002-2003).
- 男人按查尔森并发症评分分层 (0=最健康,≥4=最不健康).
- 从VA记录和2003年的医疗保险索赔中获得了PSA测试数据.
主要成果:
- 2003年,56%的老年男性接受了PSA检测.
- 随着年龄的增长,查率下降,但随着年龄组内健康状况恶化,查率并没有显著下降.
- 在85岁以上的男性中,34%的健康状况最好,36%的健康状况最差的人进行了查;非临床因素比健康状况更影响了查.
结论:
- 考虑到已知的危害,预期寿命有限的老年退伍军人中的PSA查率高于建议的水平.
- 在对老年男性的PSA查建议中,预后需要更多的考虑.
- 目前的查实践可能会导致不必要的干预和相关风险.
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