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Age dependence of modern clinical risk groups for localized prostate cancer-A population-based study.
Cancer ( IF 6.2 ) Pub Date : 2020-01-03 , DOI: 10.1002/cncr.32702
Minh-Phuong Huynh-Le 1 , Tor Åge Myklebust 2, 3 , Christine H Feng 1 , Roshan Karunamuni 1 , Tom Børge Johannesen 2 , Anders M Dale 4 , Ole A Andreassen 5 , Tyler M Seibert 1, 6
Affiliation  

BACKGROUND Optimal prostate cancer (PCa) screening strategies will focus on men likely to have potentially lethal disease. Age-specific incidence rates (ASIRs) by modern clinical risk groups could inform risk stratification efforts for screening. METHODS This cross-sectional population study identified all men diagnosed with PCa in Norway from 2014 to 2017 (n = 20,356). Age, Gleason score (primary plus secondary), and clinical stage were extracted. Patients were assigned to clinical risk groups: low, favorable intermediate, unfavorable intermediate, high, regional, and metastatic. Chi-square tests analyzed the independence of Gleason scores and modern PCa risk groups with age. ASIRs for each risk group were calculated as the product of Norwegian ASIRs for all PCa and the proportions observed for each risk category. RESULTS Older age was significantly associated with a higher Gleason score and more advanced disease. The percentages of men with Gleason 8 to 10 disease among men aged 55 to 59, 65 to 69, 75 to 79, and 85 to 89 years were 16.5%, 23.4%, 37.2%, and 59.9%, respectively (P < .001); the percentages of men in the same age groups with at least high-risk disease were 29.3%, 39.1%, 60.4%, and 90.6%, respectively (P < .001). The maximum ASIRs (per 100,000 men) for low-risk, favorable intermediate-risk, unfavorable intermediate-risk, high-risk, regional, and metastatic disease were 157.1 for those aged 65 to 69 years, 183.8 for those aged 65 to 69 years, 194.8 for those aged 70 to 74 years, 408.3 for those aged 75 to 79 years, 159.7 for those aged ≥85 years, and 314.0 for those aged ≥85 years, respectively. At the ages of 75 to 79 years, the ASIR of high-risk disease was approximately 6 times greater than the ASIR at 55 to 59 years. CONCLUSIONS The risk of clinically significant localized PCa increases with age. Healthy older men may benefit from screening.

中文翻译:

局部前列腺癌的现代临床风险人群的年龄依赖性(基于人群的研究)。

背景技术最佳的前列腺癌(PCa)筛查策略将集中于可能具有潜在致命性疾病的男性。现代临床风险人群的年龄特定发病率(ASIR)可以为筛查风险分层工作提供依据。方法这项横断面人群研究确定了2014年至2017年挪威所有诊断为PCa的男性(n = 20,356)。提取年龄,格里森评分(初次加次要)和临床分期。将患者分为临床危险组:低,中等,不利,中等,高,区域性和转移性。卡方检验分析了格里森评分和现代PCa风险人群随年龄增长的独立性。将每个风险组的ASIR计算为所有PCa的挪威ASIR和每个风险类别所观察到的比例的乘积。结果年龄与格里森评分较高和疾病晚期显着相关。55至59岁,65至69岁,75至79岁和85至89岁的男性中患有格里森氏8至10病的男性分别为16.5%,23.4%,37.2%和59.9%(P <.001 ); 同一年龄组中至少患有高危疾病的男性百分比分别为29.3%,39.1%,60.4%和90.6%(P <.001)。低危,有利中危,不利中危,高危,区域性和转移性疾病的最高ASIR(每100,000名男性)为65-69岁的人为157.1,65-69岁的人为183.8分别为70岁至74岁的194.8岁,75至79岁的408.3岁,≥85岁的159.7岁和85岁以上的314.0岁。在75到79岁之间,高危疾病的ASIR在55至59岁时约为ASIR的6倍。结论临床上显着的局部PCa的风险随年龄增长而增加。健康的老年男性可能会受益于筛查。
更新日期:2020-01-04
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