Screening for prostate cancer: Updated experience from the Tyrol study

被引:12
作者
Horninger W. [1 ]
Berger A. [1 ]
Pelzer A. [1 ]
Klocker H. [1 ]
Oberaigner W. [1 ]
Schönitzer D. [1 ]
Severi G. [1 ]
Robertson C. [1 ]
Boyle P. [1 ]
Bartsch G. [1 ]
机构
[1] Department of Urology, University of Innsbruck, Anichstrasse 35, Innsbruck
关键词
Prostate Cancer; Prostate Cancer Mortality; Prostate Cancer Screening; Radical Prostatectomy; Tyrol;
D O I
10.1007/s11934-004-0040-8
中图分类号
学科分类号
摘要
The aim of the Tyrol study was to monitor the impact of screening in a natural experiment by comparing prostate cancer mortality in Tyrol, where prostate-specific antigen (PSA) testing was introduced at no charge, with the rest of Austria, where it was not strictly organized and not free of charge. In 1993, PSA testing was made freely available to men between the ages of 45 and 75 years in the Federal State of Tyrol, Austria. At least 70% of all of the men in this age range have been tested at least once during the first 10 years of the study. Initially, only total PSA was measured, but free PSA measurement was added in 1995. Since 2001, complexed PSA also has been measured. Digital rectal examination was not part of the screening examination. Significant migration to lower clinical and pathological stages has been observed since the introduction of this screening program. These findings are consistent with the hypothesis that the policy of making PSA testing freely available, and the wide acceptance by men in the population, is associated with a reduction in prostate cancer mortality in an area in which urology services and radiotherapy are available freely to all patients. It is our opinion that most of this decline is likely a result of aggressive downstaging and successful treatment and that any contribution from detecting and treating early cancers will become apparent in the years to come. © 2004, Current Science Inc.
引用
收藏
页码:220 / 225
页数:5
相关论文
共 30 条
[21]  
Von Eschenbach A., Ho R., Murphy G.P., Et al., Guidelines for the early detection of prostate cancer, Cancer, 80, pp. 1805-1807, (1997)
[22]  
Smart C.R., The results of prostate carcinoma screening in the U.S. as reflected in the surveillance, epidemiology, and end results program, Cancer, 80, pp. 1835-1844, (1997)
[23]  
Hankey B.F., Feuer E.J., Clegg L.X., Et al., Cancer surveillance series: interpreting trends in prostate cancer-part I. Evidence of the effects of screening in recent prostate cancer incidence, mortality, and survival rates, J Natl Cancer Inst, 91, pp. 1017-1024, (1999)
[24]  
Feuer J., Merrill R.M., Hankey B.F., Cancer surveillance series: interpreting trends in prostate cancer-part II. Cause of death misclassification and the recent rise and fall in prostate cancer mortality, J Natl Cancer Inst, 91, pp. 1025-1032, (1999)
[25]  
Etzioni R., Legler J.M., Feuer E.J., Et al., Cancer surveillance series: interpreting trends in prostate cancer-part III: quantifying link between population prostate specific antigen testing and recent declines in prostate cancer mortality, J Natl Cancer Inst, 91, pp. 1033-1039, (1999)
[26]  
Jacobsen S.J., Bergstralh E.J., Katusic S.K., Et al., Screening digital rectal examination and prostate cancer mortality: a population-based case-control study, Urology, 52, pp. 173-179, (1998)
[27]  
Boyle P., Prostate-specific antigen (PSA) testing as screening for prostate cancer: the current controversy, Ann Oncol, 9, pp. 1263-1264, (1998)
[28]  
Laara E., Day N.E., Hakama M., Trends in mortality from cervical cancer in the Nordic countries: association with organized screening programs, Lancet, 1, pp. 1247-1249, (1987)
[29]  
van den Akker-van Marle E., de Konig H., Boer R., Et al., Reduction in breast cancer mortality due to the introduction of mass screening in The Netherlands: comparison with the United Kingdom, J Med Screen, 6, pp. 30-34, (1999)
[30]  
Messing E.M., Manola J., Sarosdy M., Et al., Immediate hormonal therapy compared with observation after radical prostatectomy and pelvic lymphadenectomy in men with node positive prostate cancer, N Engl J Med, 341, pp. 1781-1788, (1999)