英格兰的前列腺特异性抗原再检测间隔和趋势:基于人口的队列研究
Kiana K Collins1, Jason L Oke2, Pradeep S Virdee2
1Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK kiana.collins@phc.ox.ac.uk.
BMJ (Clinical research ed.)
|October 8, 2025
概括
英格兰的前列腺特异性抗原 (PSA) 测试显示出显著的差异,许多患者经常接受重复测试,引发了对过度测试的担忧. 需要进一步的研究,以建立基于证据的PSA再测试间隔,以获得最佳的患者益处和降低风险.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 主要护理医学 医疗保健
- 医疗保健服务研究 医疗服务研究
背景情况:
- 前列腺特异性抗原 (PSA) 测试是前列腺癌诊断的关键工具.
- 在初级保健中了解PSA测试模式对于适当的使用至关重要.
研究的目的:
- 描述英格兰的初级保健系统中PSA测试的使用情况.
- 确定影响PSA测试频率和重复测试间隔的趋势和因素.
主要方法:
- 一项以人口为基础的,开放的队列研究,利用来自英格兰1442个一般实践 (2000-2018) 的数据.
- 来自国家癌症登记,医院病例统计和国家统计局的链接数据.
- 分析包括时间趋势,年龄标准化率和混合效应模型,以检查基于各种患者和临床因素的测试和重新测试间隔.
主要成果:
- 超过150万名患者接受了超过380万次PSA测试.
- 很大一部分 (48.4%) 进行了多次测试,其中许多 (72.8%) 从未超过转诊值.
- 平均重新测试间隔为12.6个月,根据年龄,种族,家族史和PSA水平观察到的变化,尽管间隔在不同地区和贫困水平上是相似的.
结论:
- 在英格兰的初级保健中,PSA测试的做法是不同的.
- 有关过度测试存在担忧,因为许多多次测试的患者比推的更频繁地重新测试,有时没有症状或PSA值较低.
- 迫切需要进行研究,以建立基于证据的PSA再测试间隔,以最大限度地提高患者的益处,并最大限度地降低过度测试的风险.
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