预期寿命对前列腺癌查共享决策的影响
Myles M Reed1, Jialin Mao2,3, Meenakshi Davuluri3,4
1MD Program, Weill Cornell Medical College, New York, NY, USA.
Cancer causes & control : CCC
|September 10, 2025
概括
预期寿命较短的男性不太可能接受前列腺癌 (PCa) 查的共享决策 (SDM). 将预期寿命纳入PCa查讨论中对于改善患者结果至关重要.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 预防医学 预防医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 美国预防服务工作组 (USPSTF) 建议在55-69岁的男性进行前列腺癌 (PCa) 查的共享决策 (SDM).
- 对于69岁以上的男性或寿命有限的男性,不建议进行常规PCa查.
研究的目的:
- 评估个人预期寿命与PCa查SDM的接收和内容之间的关联.
- 调查预期寿命如何影响关于PCa查风险和益处的讨论.
主要方法:
- 对2020年行为风险因素监测系统调查数据的分析.
- 包括50岁及以上,没有PCa病史的男性受访者.
- 使用经过验证的指数 (年龄,并发症,日常活动) 估计预期寿命,并将SDM定义为事先讨论PSA测试的好坏.
主要成果:
- 在70-74岁的男性中,共享决策 (SDM) 收到率最高 (62.6%).
- 与期望寿命最高的男性相比,期望寿命最低的男性接受SDM的可能性较低 (aOR=0.84).
- SDM讨论的内容 (优点/缺点) 不因年龄或预期寿命而有所不同;近期查的男性中有14.5%报告之前没有SDM.
结论:
- 预期寿命在PCa查决策中没有得到充分考虑.
- 需要增强的工具来支持SDM对话用于PCa选.
- 改进SDM可以优化PCa查在人口层面的好处和危害.
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