Ethnicity and prostate cancer: the way to solve the screening problem?

BMC Medicine

Monique J. Roobol¹  Leonard P. Bokhorst¹ 

[1] Department of Urology, Erasmus University Medical Center, Rotterdam, The Netherlands

关键词: Screening;    Risk stratification;    Race;    Prostatic neoplasms;    Prostate-specific antigen;    Mortality;    Incidence;   

Others  :  1222391
DOI  :  10.1186/s12916-015-0427-z

 received in 2015-07-17, accepted in 2015-07-17,  发布年份 2015

【 摘 要 】

In their analysis in BMC Medicine, Lloyd et al. provide individual patient lifetime risks of prostate cancer diagnosis and prostate cancer death stratified by ethnicity. This easy to understand information is helpful for men to decide whether to start prostate-specific antigen testing (i.e. screening). A higher lifetime risk of prostate cancer death in some ethnic groups is not automatically a license to start screening. The potential benefit in the form of reducing metastases and death should still be weighed against the potential risk of over diagnosis. In case of ethnicity, this harm-to-benefit ratio does not differ between groups. Stratifying men for screening based on ethnicity is therefore not optimal and will not solve the current screening problem. Other methods for risk-stratifying men have been proven to produce a more optimal harm-to-benefit ratio.

Please see related article: http://www.biomedcentral.com/1741-7015/13/171

【 授权许可】

   
2015 Bokhorst and Roobol.

【 参考文献 】

• [1]Schroder FH, Hugosson J, Roobol MJ, Tammela TL, Zappa M, Nelen V et al.. ERSPC Investigators. Screening and prostate cancer mortality: results of the European Randomised Study of Screening for Prostate Cancer (ERSPC) at 13 years of follow-up. Lancet. 2014; 384:2027-35.
• [2]Andriole GL, Crawford ED, Grubb RL, Buys SS, Chia D, Church TR et al.. Prostate cancer screening in the randomized prostate, lung, colorectal, and ovarian cancer screening trial: mortality results after 13 years of follow-up. J Natl Cancer Inst. 2012; 104:125-32.
• [3]European Randomized study of Screening for Prostate Cancer. www.erspc.org. Last accessed at July 23, 2015
• [4]Heijnsdijk EA, Wever EM, Auvinen A, Hugosson J, Ciatto S, Nelen V et al.. Quality-of-life effects of prostate-specific antigen screening. N Engl J Med. 2012; 367:595-605.
• [5]Schroder FH, Hugosson J, Carlsson S, Tammela T, Määttänen L, Auvinen A et al.. Screening for prostate cancer decreases the risk of developing metastatic disease: findings from the European Randomized Study of Screening for Prostate Cancer (ERSPC). Eur Urol. 2012; 62:745-52.
• [6]Bokhorst LP, Bangma CH, van Leenders GJ, Lous JJ, Moss SM, Schröder FH et al.. Prostate-specific antigen-based prostate cancer screening: reduction of prostate cancer mortality after correction for nonattendance and contamination in the Rotterdam section of the European randomized study of screening for prostate cancer. Eur Urol. 2014; 65:329-36.
• [7]Loeb S, Bjurlin MA, Nicholson J, Tammela TL, Penson DF, Carter HB et al.. Overdiagnosis and overtreatment of prostate cancer. Eur Urol. 2014; 65:1046-55.
• [8]Draisma G, Boer R, Otto SJ, van der Cruijsen IW, Damhuis RA, Schröder FH et al.. Lead times and overdetection due to prostate-specific antigen screening: estimates from the European Randomized Study of Screening for Prostate Cancer. J Natl Cancer Inst. 2003; 95:868-78.
• [9]Roobol MJ, Carlsson SV. Risk stratification in prostate cancer screening. Nat Rev Urol. 2013; 10:38-48.
• [10]Heidenreich A, Bastian PJ, Bellmunt J, Bolla M, Joniau S, van der Kwast T et al.. EAU guidelines on prostate cancer. Part 1: screening, diagnosis, and local treatment with curative intent-update 2013. Eur Urol. 2014; 65:124-37.
• [11]Carter HB, Albertsen PC, Barry MJ, Etzioni R, Freedland SJ, Greene KL et al.. Early detection of prostate cancer: AUA Guideline. J Urol. 2013; 190:419-26.
• [12]Lloyd T, Hounsome L, Mehay A, Mee S, Verne J, Cooper A. Lifetime risk of being diagnosed with, or dying from, prostate cancer by major ethnic group in England 2008–2010. BMC Medicine. 2015; 13:171. BioMed Central Full Text
• [13]Evans S, Metcalfe C, Ibrahim F, Persad R, Ben-Shlomo Y. Investigating Black-White differences in prostate cancer prognosis: a systematic review and meta-analysis. Int J Cancer. 2008; 123:430-5.
• [14]Heijnsdijk EA, de Carvalho TM, Auvinen A, Zappa M, Nelen V, Kwiatkowski M et al.. Cost-effectiveness of prostate cancer screening: a simulation study based on ERSPC data. J Natl Cancer Inst. 2015; 107:366.
• [15]Vickers AJ, Ulmert D, Sjoberg DD, Bennette CJ, Björk T, Gerdtsson A et al.. Strategy for detection of prostate cancer based on relation between prostate specific antigen at age 40–55 and long term risk of metastasis: case–control study. BMJ. 2013; 346:f2023.
• [16]Vertosick EA, Poon BY, Vickers AJ. Relative value of race, family history and prostate specific antigen as indications for early initiation of prostate cancer screening. J Urol. 2014; 192:724-8.
• [17]Alberts A, Schoots IG, Bokhorst LP, Bangma CH, Roobol MJ. Improved patient selection for MRI-targeted prostate biopsy after negative random biopsy with the Rotterdam Prostate Cancer Risk Calculator. Eur Urol Suppl. 2015; 14:e770.
• [18]Zhu X, Albertsen PC, Andriole GL, Roobol MJ, Schroder FH, Vickers AJ. Risk-based prostate cancer screening. Eur Urol. 2011; 61:652-61.
• [19]Roobol MJ, Steyerberg EW, Kranse R, Wolters T, van den Bergh RC, Bangma CH et al.. A risk-based strategy improves prostate-specific antigen-driven detection of prostate cancer. Eur Urol. 2010; 57:79-85.