Prostate-specific Antigen Screening and Recent Increases in Advanced Prostate Cancer
Menée aux Etats-Unis à partir des données des registres des cancers et de deux modèles de projection, cette étude analyse la corrélation entre l'augmentation observée de l'incidence des cancers métastatiques de la prostate et la réduction des examens de dépistage par dosage du PSA débutée après les recommandations 2008 et 2012 de l'"United States Preventive Services Task Force"
Recent studies show decreasing prostate-specific antigen utilization and increasing incidence of metastatic prostate cancer in the United States after national recommendations against screening in 2012. Yet whether the increasing incidence of metastatic prostate cancer is consistent in magnitude with the expected impact of decreased screening is unknown. We compared observed incidence of metastatic prostate cancer from the Surveillance, Epidemiology, and End Results program and published effects of continued historical screening and discontinued screening starting in 2013 projected by two models of disease natural history, screening, and diagnosis. The observed rate of new metastatic prostate cancer cases in 2017 was 44%-60% of the projected increase under discontinued screening relative to continued screening. Thus, the observed increase in incident metastatic prostate cancer is consistent with the expected impact of reduced screening. Although this comparison does not establish a causal relationship, it highlights the plausible role of decreased screening in the observed trend.
JNCI Cancer Spectrum , article en libre accès, 2019