在黑人和非西班牙裔白人男性中,预诊断前列腺特异抗原与前列腺癌概率之间的关联
Kyung Min Lee1,2, Alex K Bryant3,4, Julie A Lynch1,2
1VA Informatics and Computing Infrastructure, VA Salt Lake City Health Care System, Salt Lake City, Utah, USA.
Cancer
|November 6, 2023
概括
黑人男性患前列腺癌的风险比白人男性高50%,即使前列腺特异性抗原 (PSA) 水平较低. 这凸显了针对黑人男性的量身定制查方案的需要,因为他们的风险增加了.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 在瘤学瘤学.
- 公共卫生 公共卫生
背景情况:
- 前列腺癌不成比例地影响黑人男性,但查指南缺乏针对这一人口群的具体建议.
- 现有的数据不足以指导针对黑人男性的前列腺特异性抗原 (PSA) 查协议.
研究的目的:
- 调查自认的黑人退伍军人是否比白人退伍军人患前列腺癌的风险高于预期,基于预剖 PSA 水平.
- 为了确定PSA查值是否需要对黑人男性进行调整.
主要方法:
- 在一个由75,295名黑人和207,658名白人男性退伍军人组成的队列上利用了多变量后勤回归.
- 包括诸如种族,PSA测试时的年龄,PSA预解剖,吸烟状态,他类药物的使用和社会经济因素等预测因素.
- 在各种PSA水平上计算出前列腺癌检测的调整预测概率.
主要成果:
- 黑人退伍军人在第一次活检时被诊断患有前列腺癌的可能性比白人退伍军人高50% (OR,1.50).
- 在4.0ng/mL的PSA水平下,黑人男性患癌症的概率为49%,而白人男性患癌症的概率为39%.
- 黑人退伍军人的PSA水平为4.0 ng/mL表明,与白人退伍军人的PSA水平为13.4 ng/mL相等的前列腺癌风险.
结论:
- 在任何特定的PSA水平下,黑人男性患前列腺癌的可能性高于白人男性.
- 研究结果表明,目前的PSA查值可能低估了黑人男性的风险.
- 进一步的前性研究对于完善查方案和评估高风险人群 (包括黑人男性) 的风险/益处至关重要.
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