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首页> 外文期刊>BMC Family Practice >Prostate-specific antigen (PSA) screening and follow-up investigations in Māori and non-Māori men in New Zealand
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Prostate-specific antigen (PSA) screening and follow-up investigations in Māori and non-Māori men in New Zealand

机译：新西兰毛利人和非毛利人的前列腺特异性抗原（PSA）筛查和随访研究

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Background Māori men in New Zealand have higher mortality from prostate cancer, despite having lower incidence rates. The objective of this study was to examine patterns of screening for prostate cancer in primary care and follow-up investigations after an elevated prostate-specific antigen (PSA) result in Māori and non-Māori men in order to help explain the observed differences in incidence and mortality. Methods Men aged 40+ years were identified from 31 general practices across the Midland Cancer Network region. Computerised practice records were cross-referenced with laboratory data to determine the number and value of PSA tests undertaken between January 2007 and December 2010. Screening rates were calculated for the year 2010 by age, ethnicity, and practice. For men with an elevated PSA result information on specialist referrals and biopsy was extracted from practice records. Practice characteristics were assessed with respect to screening rates for Māori and non-Māori men. Results The final study population included 34,960 men aged 40+ years; 14% were Māori. Māori men were less likely to be screened in 2010 compared with non-Māori men (Mantel Haenszel (M-H) age-adjusted risk ratio (RR), 0.52 [95% CI, 0.48, 0.56]). When screened, Māori men were more than twice as likely to have an elevated PSA result compared with non-Māori men (M-H age-adjusted RR, 2.16 [95% CI, 1.42, 3.31]). There were no significant differences between Māori and non-Māori men in the rate of follow-up investigations and cancer detection. Māori provider practices showed equal screening rates for Māori and non-Māori men, but they were also the practices with the lowest overall screening rates. Conclusions Māori men were half as likely to be screened compared to non-Māori men. This probably explains the lower reported incidence of prostate cancer for Māori men. Practice characteristics had a major influence on screening rates. Large variation in screening behaviour among practices and differences in follow-up investigations for men with an elevated PSA result seems to reflect the uncertainty among GPs regarding PSA screening and management.
机译：背景技术新西兰的毛利人尽管发病率较低，但前列腺癌死亡率较高。这项研究的目的是检查在毛利人和非毛利人中前列腺特异性抗原（PSA）升高后在初级保健中筛查前列腺癌的模式以及后续调查，以帮助解释观察到的发病率差异和死亡率。方法从Midland癌症网络区域的31种常规实践中识别出40岁以上的男性。计算机化的实践记录与实验室数据进行了对照，以确定在2007年1月至2010年12月之间进行的PSA测试的数量和价值。根据年龄，种族和实践对2010年的筛查率进行了计算。对于PSA升高的男性，从实践记录中提取了有关专科转诊和活检的信息。根据毛利人和非毛利人的筛查率评估了实践特征。结果最终研究人群包括34,960名40岁以上的男性;毛利人占14％。与非毛利人相比，2010年接受毛利人筛查的可能性较小（Mantel Haenszel（M-H）年龄调整后的风险比（RR）为0.52 [95％CI，0.48，0.56]）。进行筛查后，毛利男性的PSA结果升高的可能性是非毛利男性的两倍（M-H年龄调整后的RR，2.16 [95％CI，1.42，3.31]）。毛利人和非毛利人之间的随访调查和癌症检测率均无显着差异。毛利提供者的做法显示出对毛利人和非毛利人的筛查率均等，但它们也是总筛查率最低的做法。结论毛利人被筛查的可能性是非毛利人的一半。这可能解释了毛利男性前列腺癌发病率较低的报道。实践特征对筛查率有重大影响。对于PSA结果升高的男性，实践中的筛查行为存在很大差异，而随访研究也存在差异，这似乎反映了GP之间关于PSA筛查和管理的不确定性。

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