Impact of screening and diagnostic intensity on the study of prostate cancer epidemiology

筛查和诊断强度对前列腺癌流行病学研究的影响

• 批准号: 9811066
• 负责人: EDWARD GIOVANNUCCI
• 金额: $ 7.98万
• 依托单位: HARVARD SCHOOL OF PUBLIC HEALTH
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-07-01 至 2021-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9811066
• 关键词: Accounting; Address; Age; Behavior; Biopsy; Characteristics; Clinical; Collection; Data; Data Analytics; Data Collection; Demographic Factors; Detection; Diabetes Mellitus; Diagnosis; Diagnostic; Diagnostic Procedure; Diet; Early Diagnosis; Early treatment; Epidemiology; Failure; Family; Follow-Up Studies; Future; Goals; Health Professional; Incidence; Light; Link; Localized Disease; Longterm Follow-up; Malignant Neoplasms; Malignant neoplasm of prostate; Measures; Methodology; Methods; Obesity; Outcome; Pattern; Pharmaceutical Preparations; Physical activity; Prevention; Probability; Prospective cohort; Prostate-Specific Antigen; Public Health; Race; Recording of previous events; Relative Risks; Reproducibility; Resources; Risk; Risk Factors; Screening Result; Screening for Prostate Cancer; Smoking; Source; Testing; Time; Update; Vasectomy; Work; analytical method; cancer diagnosis; cancer epidemiology; cancer prevention; cancer survival; cohort; epidemiology study; follow-up; health seeking behavior; improved; lifestyle data; lifestyle factors; male health; men; modifiable risk; mortality; prostate biopsy; prostate cancer risk; response; screening; willingness

PROJECT SUMMARY Many lifestyle factors have been examined as possible prostate cancer risk factors, but results are inconsistent across studies. It is possible that failure to adequately account for differences in PSA screening and diagnostic intensity explains some of these inconsistencies. The introduction of PSA screening for prostate cancer in the late 1980s has had a major impact on prostate cancer epidemiology, with a sustained increase in incidence rates, a shift to more localized disease, and decreased mortality rates. Both screening and willingness to undergo a prostate biopsy, the diagnostic procedure that follows an elevated PSA, are associated with various demographic and lifestyle factors. These differences in men’s PSA screening and biopsy behaviors may distort the estimated effects of lifestyle factors on prostate cancer risk, but few attempts have been made to quantitatively assess this source of possible bias. Our scientific premise is that appropriately accounting for the impact of screening and biopsy is necessary to elucidate the underlying associations between lifestyle factors and prostate cancer risk. The objective of this project is to study the impact of screening and propensity for biopsy on the association between demographic and lifestyle factors and prostate cancer. This will support more rigorous interpretation of existing studies of prostate cancer epidemiology and inform data collection and analytic methods for future studies. We will use data from a large, on-going cohort, the Health Professionals Follow-up Study (HPFS), a unique resource which has collected information on the use of PSA screening and prostate biopsy every two years since 1996, and also has updated information on an array of lifestyle factors, and information on prostate cancer diagnosis and survival. In Aim 1, we will investigate how patterns of prostate cancer screening and biopsy are associated (a) with demographic and lifestyle factors, including: age, race, family history, smoking, obesity, physical activity, diet, and medication usage, and (b) with risk of prostate cancer. In Aim 2, we will use several analytic approaches to study how these lifestyle factors are associated with prostate cancer risk, independent of screening and biopsy practices. This study efficiently leverages a unique collection of existing data to provide the first comprehensive assessment of the impact of prostate cancer screening and diagnosis behaviors on prostate cancer risk factors. By characterizing and quantifying this detection bias, this project will aid in the interpretation of existing studies of prostate cancer risk factors and provide direction to future studies on data collection and analytic methods to better handle these issues. Overall, we hope that this work will shed light on previous inconsistencies in findings on prostate cancer risk factors and support more rigorous identification of risk factors for prostate cancer, supporting public health prevention efforts.

项目概要 许多生活方式因素已被检查为可能的前列腺癌危险因素，但结果是 各研究之间可能存在不一致的情况，未能充分考虑 PSA 筛查的差异。 诊断强度可以解释其中一些不一致之处。 20 世纪 80 年代末引进的前列腺癌 PSA 筛查对前列腺癌产生了重大影响。 前列腺癌流行病学，发病率持续上升，疾病向更局部的方向转变， 筛查和接受前列腺活检（诊断手段）的意愿均降低。 PSA 升高后进行的手术与各种人口和生活方式因素有关。 男性 PSA 筛查和活检行为的差异可能会扭曲生活方式因素的估计影响 前列腺癌风险，但很少有人尝试定量评估这种可能的偏差来源。 我们的科学前提是，有必要适当考虑筛查和活检的影响 阐明生活方式因素与前列腺癌风险之间的潜在关联。 该项目的目的是研究筛查和活检倾向对 人口和生活方式因素与前列腺癌之间的关联这将支持更严格的研究。 解释前列腺癌流行病学的现有研究并为数据收集和分析提供信息 我们将使用来自大型、持续的队列“健康专业人员随访”的数据。 研究 (HPFS)，一个独特的资源，收集了有关使用 PSA 筛查和前列腺的信息 自 1996 年以来每两年进行一次活检，并更新了一系列生活方式因素的信息，以及 有关前列腺癌诊断和生存的信息 在目标 1 中，我们将研究前列腺癌的模式。 癌症筛查和活检与 (a) 人口和生活方式因素相关，包括：年龄、种族、 家族史、吸烟、肥胖、体力活动、饮食和药物使用，以及 (b) 有前列腺风险 在目标 2 中，我们将使用多种分析方法来研究这些生活方式因素之间的关联。 具有癌症风险，独立于筛查和前列腺活检实践。 这项研究有效地利用了现有数据的独特集合，提供了第一个全面的 评估前列腺癌筛查和诊断行为对前列腺癌风险的影响 通过表征和量化这种检测偏差，该项目将有助于解释现有的因素。 前列腺癌危险因素的研究，并为未来的数据收集和分析研究提供方向 总的来说，我们希望这项工作能够为以前的工作提供启发。 前列腺癌危险因素的研究结果不一致，支持更严格的风险识别 前列腺癌的因素，支持公共卫生预防工作。