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：这是先前拨款的重新提交。 调查人员 提议评估“自然实验”的结果以确定是否 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 SEER 地区的临床医生更加积极地尝试 及早发现前列腺癌（尤其是前列腺特异性抗原） 或 PSA 测试）并积极治疗（特别是“PSA 时代”（1987-1990）。 在 PSA 时代之前，这些地区基于人群的前列腺癌死亡率 两者本质上是相同的。 他们的自然实验重点 主要针对西雅图约 75,000 名男性和康涅狄格州约 95,000 名男性的群体 年龄在 65-74 岁（预期寿命至少为 10 年）的人以及 至少到 1990 年为止各自地区的居民。 1987年至1990年期间，他们已经确定西雅图的男人 队列中接受前列腺活检的可能性约为两倍 被诊断患有前列腺癌，接受前列腺癌治疗的可能性是其六倍 根治性前列腺切除术高于康涅狄格州队列中的男性。 事实上， 1987 年至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%（大约是该群体中愿意接受治疗的男性比例） 最终预计死于前列腺癌），相比之下，这一比例不到 1% 康涅狄格州队列。 他们建议继续跟进这两起事件 2001 日历年或自该组织成立后 15 年 队列。 在此期间，他们预计会看到减少 西雅图与康涅狄格州以人口为基础的前列腺癌死亡率 如果按照实际情况进行早期发现和积极治疗 社区确实是一个有效的策略。