最近接受前列腺特异抗原查的70岁男性的前列腺癌死亡率
Dana H Chung1, Tanner J Caverly2,3, Matthew J Schipper4,5
1University of Michigan Medical School, Ann Arbor.
JAMA network open
|February 14, 2025
概括
在70岁以后继续进行前列腺特异性抗原 (PSA) 查可能有利于高危男性. 在65-69岁之间,基线PSA低于1ng/mL,表明70岁后前列腺癌死亡率或转移的风险非常低.
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:
- 在70岁以后继续进行前列腺特异性抗原 (PSA) 查,可能有利于某些患前列腺癌特异性死亡率 (PCSM) 或转移性前列腺癌 (mPCa) 高风险的男性.
- 种族,种族,竞争性死亡率和PSA史等临床因素在识别这些高风险男性中的相对重要性仍然不清楚.
研究的目的:
- 评估PSA水平,种族和种族以及竞争性死亡率在70岁及以上男性PCSM和mPCa风险分层中的有用性.
- 为了为临床决策提供有关老年男性持续PSA查的信息.
主要方法:
- 一项队列研究分析了退伍军人卫生管理局内70岁 (2008-2020) 的921,609名男性的临床数据.
- 被纳入的男性在65-69岁之间具有正常的PSA基线 (<4 ng/mL),并且以前没有前列腺癌史.
- 风险分层利用PSA水平,种族/种族,以及机器学习衍生的竞争性死亡风险评分来预测10年的PCSM和mPCa.
主要成果:
- 大多数男性 (87%) 在70岁以后继续进行PSA查,风险因素差异很小.
- 较高的PSA基线水平 (3.00-3.99 ng/mL) 与较低水平 (0.20-0.99 ng/mL) 相比,与10年PCSM风险增加有关.
- 基线PSA<1 ng/mL表明PCSM和mPCa的10年风险非常低,即使在高风险的人口群体中也是如此.
结论:
- 该研究表明,大多数男性在70岁以后继续进行PSA查,尽管PCSM10年绝对风险普遍较低.
- 70岁前的PSA水平对长期结果具有很高的预测性,PSA<1 ng/mL表明PCSM和mPCa的风险非常低.
- 这些发现支持基于70前PSA值的个性化查策略.
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