高风险患者的前列腺癌查实践:回顾性分析
Aditya K Ghosh1, Barath P Sivasubramanian2, Rana H Asif2
1Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA.
American journal of men's health
|November 20, 2025
概括
前列腺特异性抗原 (PSA) 查前列腺癌在初级保健中不一致. 虽然更多的风险因素增加了检测,但非洲裔美国人和低收入男性仍未得到检测,这凸显了改善查公平的需要.
科学领域:
- 在瘤学瘤学.
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 前列腺癌是美国男性的主要癌症,不成比例地影响非裔美国人.
- 指南建议通过前列腺特异性抗原 (PSA) 查进行早期检测,但其在初级保健中的应用是不一致的.
- 了解查模式和风险因素关联对于改善结果至关重要.
研究的目的:
- 在初级保健中评估前列腺特异性抗原 (PSA) 查模式.
- 分析患者风险因素与PSA检测率之间的关联.
- 为了确定前列腺癌查中的差异.
主要方法:
- 从初级保健诊所 (2020-2022) 追溯分析了176,326名40岁以上的男性.
- 开发基于前列腺癌风险因素的风险评分.
- 单变量和多变量分析以检查风险得分,PSA查和癌症诊断之间的关联.
主要成果:
- 只有31.4%的患者接受了PSA测试;测试增加到78.1%,风险分数为4.
- 较高的PSA测试几率与医疗补助/商业保险,前/从未吸烟状态,年龄较大,非洲裔美国人种族和家族史有关.
- 前列腺癌诊断发生在25%的患者中,风险分数为5,预测年龄较大,非洲裔美国人种族和家族史.
结论:
- 前列腺特异性抗原 (PSA) 查在初级保健中未得到充分利用,即使是高危人群.
- 虽然风险因素与测试增加相关,但差异仍然存在,非洲裔美国人和低收入人群的测试不足.
- 建议提供者教育和决策支持工具,以加强指导方针的遵守,并促进公平的查.
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