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低风险前列腺癌的风险因素:FinRSPC试验中的回顾性队列研究
Uzoamaka E Okwor1, Jani Raitanen1,2, Kirsi Talala3
1Faculty of Social Sciences, Tampere University, Tampere, Finland.
International journal of cancer
|July 17, 2025
概括
前列腺癌 (PC) 查导致低风险PC的过度诊断. 低风险PC的风险因素与高风险PC不同,似乎与医疗服务的使用有关,而不是年龄.
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:
- 基于前列腺特异性抗原 (PSA) 的前列腺癌 (PC) 查与低风险PC的过度诊断和过度治疗有关.
- PSA 查的整体益处和危害的平衡仍然是争论的主题.
- 了解低风险与高风险PC的不同决定因素对于完善选策略至关重要.
研究的目的:
- 在接受PSA查的大群中,将低风险PC的决定因素与高风险PC的决定因素进行比较.
- 调查查对PC的不同风险类别发病率的影响.
- 确定与低风险PC相关的因素,这些因素可能与与高风险PC相关的因素不同.
主要方法:
- 来自芬兰前列腺癌查随机研究的80,144名男性的回顾性队列研究.
- 基于欧洲泌尿病学协会指南的低风险PC的分类,不包括PC死亡或进展.
- 普森回归分析用于在查和控制臂之间比较PC发病率和相关风险因素.
主要成果:
- 低风险的PC发病率在查手臂 (1.9每1000人年) 比对照手臂 (1.2每1000人年) 高.
- 在查 (5.4) 和控制 (5.7) 臂之间,高风险PC发生率相似.
- 风险因素,如家族病史和使用5α减少酶抑制剂,与低风险的PC有较强的关联,表明不同的病因路径.
- 年龄与高风险的PC有关,但与低风险的PC无关.
结论:
- 查增加了低风险前列腺癌的检测,而高风险的PC发病率并没有通过查显著增加.
- 独特的风险因素将低风险与高风险的前列腺癌区分开来,医疗服务的利用可能在低风险的检测中发挥作用.
- 研究结果表明,目前的查实践可能导致过度诊断惰性PC,需要重新评估查方案和风险分层.
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