前列腺癌基金会为美国黑人男性的查指南
Isla P Garraway1, Sigrid V Carlsson2,3, Yaw A Nyame4,5
1Department of Urology, David Geffen School of Medicine, University of California and Department of Surgical and Perioperative Care, VA Greater Los Angeles Healthcare System, Los Angeles.
NEJM evidence
|May 30, 2024
概括
黑人男性面临更高的前列腺癌风险. 新的指导方针建议在40-45岁之间开始前列腺特异性抗原 (PSA) 查讨论,以减少死亡率.
科学领域:
- 在瘤学瘤学.
- 公共卫生 公共卫生
- 预防医学 预防医学
背景情况:
- 在美国,黑人男性的前列腺癌诊断和死亡率不成比例地高.
- 现有的查指南可能无法充分解决这一人口群体面临的特定风险.
研究的目的:
- 建立针对美国黑人男性的临床前列腺特异性抗原 (PSA) 查指南.
- 为了解决前列腺癌发病率的显著健康差异.
主要方法:
- 在遵循PRISMA指南的系统文献搜索中,发现了264项相关研究.
- 分析包括随机对照试验,观察研究和建模研究.
- 综合了证据,以告知 PSA 查的年龄,频率和终止.
主要成果:
- 一级证据表明,50-74岁的平均风险男性的PSA查可以减少转移和死亡.
- 观察和建模研究表明,黑人男性的前列腺癌发病时间比黑人男性早3-9年.
- 将基线PSA检测降低至40-45岁,并定期查至70岁,可以在没有显著的过度诊断的情况下将死亡率降低30%左右.
结论:
- 黑人男性应该被告知前列腺癌PSA查选项.
- 对于选择查的黑人男性,基线PSA检测应在40至45岁之间开始.
- 应强烈考虑根据PSA水平和健康状况进行年度查.
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