基于中年基线的致命前列腺癌未来发展的种族差异前列腺特异性抗原
Giuseppe Chiarelli1,2, Matthew Davis1, Alex Stephens3
1VUI Center for Outcomes Research, Analysis, and Evaluation, Henry Ford Health System, Detroit, Michigan, USA.
The Prostate
|December 9, 2024
概括
中年基线PSA预测致命的前列腺癌风险,但黑人男性面临的风险高于白人男性具有相似的PSA水平. 对于黑人男性,可能需要单独的查切线.
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:
- 中年基线PSA (MB PSA) 是已知的致命前列腺癌 (PCa) 的预测指标.
- 之前的研究缺乏种族多样性,这可能限制了概括性.
- 调查MB PSA预测价值的种族差异对于公平的PCa查至关重要.
研究的目的:
- 评估MB PSA对致命PCa的预测准确性的种族差异.
- 评估MB PSA在预测北美人口多元化种族群体中致命PCa的表现.
主要方法:
- 对年龄在40-59岁的白人和黑人男性队列的分析,具有MB PSA数据.
- 使用累积发病率曲线,时间依赖的ROC曲线和AUC进行预测性绩效比较.
- 多变量回归分析检查了MB PSA对致命PCa风险的影响.
主要成果:
- 包括112,967名男性 (27%是黑人). 在15年后,黑人男性 (0.55) 与白人男性 (0.13) 的致命PCa累积发病率在中位数MB PSA时更高.
- 在AUC中没有显著差异,表明MB PSA在种族之间具有相似的整体预测能力.
- 多变量回归显示,与所有年龄组的白人男性相比,黑人男性的致命PCa危险比率显著更高,PSA>中位数.
结论:
- 黑人男性比白人男性有不成比例地更高的致命PCa风险,即使与MB PSA水平和年龄相似.
- 当前的MB PSA值可能不适合所有种族群体.
- 在临床实践中为解决种族差异的PCa查提供指导,可能需要单独的MB PSA切断值.
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