PROSTATE CANCER SCREENING & MORTALITY: SEATTLE VS. CT.

前列腺癌筛查

• 批准号: 6333070
• 负责人: MICHAEL J BARRY
• 金额: $ 25.65万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-09-30 至 2005-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6333070
• 关键词: African American; Medicare /Medicaid; caucasian American; clinical research; early diagnosis; human data; human old age (65+); human therapy evaluation; longitudinal human study; male; neoplasm /cancer epidemiology; neoplasm /cancer therapy; outcomes research; prostate neoplasms; racial /ethnic difference

DESCRIPTION: This is a resubmission of a previous grant. The investigators propose to assess the outcomes of a "natural experiment" to determine whether aggressive early detection and treatment efforts are effective at reducing prostate cancer mortality for Medicare beneficiaries. In the United States, clinicians in the Seattle SEER area were much more aggressive in trying to detect prostate cancer early (particularly with the prostate-specific antigen or PSA test) and treat it aggressively (particularly "PSA era" (1987-1990). During the pre-PSA era, population-based prostate cancer mortality in these two are and was essentially identical. Their natural experiment focuses primarily on cohorts of about 75,000 men in Seattle and 95,000 men Connecticut who were age 65-74 (with at least a 10-year life expectancy) and who were residents of their respective regions through at least through 1990. During the period 1987-1990, they have already determined that the men in the Seattle cohort were about twice as likely to undergo prostate biopsy, twice as likely to be diagnosed with prostate cancer, and six times as likely to undergo a radical prostatectomy than men in the Connecticut cohort. In fact, the cumulative incidence of radical prostatectomy in the Seattle cohort from 1987- 1997 was over 3% (about the proportion of men in this cohort who would ultimately be expected to die of prostate cancer) compared to less than 1% in the Connecticut cohort. They propose to continue follow-up of these two cohorts through calendar year 2001, or 15 years from inceptions of the cohorts. Over this interval, they would expect to see a reduction in population-based prostate cancer mortality Seattle as compared to Connecticut if early detection and aggressive treatment as actually practiced in the community are indeed an effective strategy.

描述：这是先前赠款的重新提交。 调查人员 建议评估“自然实验”的结果，以确定是否是否 积极的早期检测和治疗工作可有效减少 医疗保险受益人的前列腺癌死亡率。 在美国， 西雅图先知地区的临床医生试图更具侵略性 尽早检测前列腺癌（尤其是前列腺特异性抗原 或PSA测试）并积极对待它（尤其是“ PSA ERA”（1987-1990）。 在PSA之前，基于人群的前列腺癌死亡率 两个是并且本质上是相同的。 他们的自然实验聚焦 主要是在西雅图大约75,000名男子和95,000名男子康涅狄格州 年龄65-74岁（至少有10年的预期寿命），谁 至少至1990年，其各自地区的居民。 1987 - 1990年，他们已经确定西雅图的男人 队列进行前列腺活检的可能性大约是两倍 被诊断出患有前列腺癌，发生了六倍 康涅狄格人队列中的根治性前列腺切除术比男性。 实际上， 从1987年开始，西雅图队列中根治性前列腺切除术的累积发生率 - 1997年超过3％（大约这个同类中的男人比例 最终预计将死于前列腺癌），而不到1％ 康涅狄格人队列。 他们建议继续跟进这两个 到2001日历年的同龄人，或从成立的15年 同伙。 在此间隔中，他们希望看到减少 与康涅狄格州相比，西雅图基于人群的前列腺癌死亡率 如果早期检测和积极治疗实际上是 社区确实是一个有效的策略。