低风险前列腺癌的积极监测:黑人男性的长期使用和结果
Zhiyu Qian1,2, Stephan Korn1,2, Hanna Zurl1,2
1Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Journal of the National Cancer Institute
|August 14, 2025
概括
积极监测 (AS) 是非西班牙裔黑人 (NHB) 患有低风险前列腺癌的男性的安全选择. 尽管结果相似,但NHB男性在AS/警等待 (AS/WW) 中使用不足.
科学领域:
- 在瘤学瘤学.
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 健康差异 在健康上的差异
背景情况:
- 有关非西班牙裔黑人 (NHB) 男人中低风险前列腺癌的攻击性存在担忧.
- 临床医生对积极监测 (AS) 对这一人口群体的适用性表示不确定性.
- 癌症治疗和治疗结果的种族差异是一个重大的公共卫生问题.
研究的目的:
- 为了研究使用主动监视/警等待 (AS/WW) 在NHB男性低风险前列腺癌的利用.
- 为了比较NHB和非西班牙裔白人 (NHW) 男人之间的AS/WW率.
- 评估长期前列腺癌特异性死亡率 (PCSM) 对于接受AS/WW的NHB男性.
主要方法:
- 来自SEER前列腺癌专业数据库 (2010-2020) 的106,486名患有低风险前列腺癌的男性的分析.
- 使用多变量逻辑回归的NHB和NHW男性之间的AS/WW利用率的比较.
- 竞争性风险分析,以评估10年PCSM的种族.
主要成果:
- 与NHW男性 (37.5%) 相比,AS/WW在NHB男性中使用的频率较低 (32.9%).
- 在研究期间,NHB男性的AS/WW利用率始终较低 (aOR=0.91).
- 在种族群体之间没有观察到10年PCSM的显著差异 (SHR=1.03).
结论:
- 积极监测/警等待 (AS/WW) 是NHB男性患前列腺癌风险低的安全管理选择.
- 尽管长期癌症特异性结果相似,但AS/WW在NHB人群中可能未得到充分利用.
- 解决潜在的偏见和改善准则的遵守,可以提高NHB男性的公平护理.
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