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Rise and fall of radical prostatectomy rates from 1989 to 1996.

机译：从1989年到1996年，前列腺癌根治术的发生率上升和下降。

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OBJECTIVES: To describe the changes in the rates of radical prostatectomy procedures, prostate-specific antigen (PSA) screening tests among Medicare beneficiaries, and the incidence of prostate cancer in the United States and to explain the exaggerated increase and decrease in the frequency of radical prostatectomy from 1989 to 1996. METHODS: Medicare claims data on radical prostatectomy procedures and screening PSA tests and the National Cancer Institute's Surveillance, Epidemiology, and End Results prostate cancer incidence data were used to estimate the rates of PSA testing and radical prostatectomy among Medicare beneficiaries aged 65 to 74 years and 75 years and older (population rates). The age-specific true rates of the procedure were also estimated for the incident cases of prostate cancer (the population at risk of undergoing radical prostatectomy) among the beneficiaries. RESULTS: The PSA test, prostate cancer incidence, and radical prostatectomy rates increased from 1989 to 1992. Thereafter, the incidence of prostate cancer, and the population and true rates of radical prostatectomy declined. The percentage of increase and decrease in the population rate of radical prostatectomy was approximately twice that in its true rate. CONCLUSIONS: The radical prostatectomy rates based on all Medicare beneficiaries grossly exaggerated the changes in the use of the procedure. Where possible, true rates, using the population at risk as the denominator, should be used in the studies of diagnostic and therapeutic procedures, complications, and adverse effects.
机译：目的：描述美国根治性前列腺切除术的发生率变化，美国医疗保险受益人之间的前列腺特异性抗原（PSA）筛查测试以及美国前列腺癌​​的发生率，并解释根治性前列腺癌发生率的夸大增加和减少1989年至1996年进行前列腺切除术。年龄在65至74岁之间，且年龄在75岁以上（人口比例）。还估计了受益者中前列腺癌（有可能接受根治性前列腺切除术的人群）的发病病例的年龄特定真实手术率。结果：从1989年到1992年，PSA测试，前列腺癌的发病率和前列腺癌根治术的发生率均有所上升。此后，前列腺癌的发病率以及前列腺癌根治术的人口和真实发生率均下降了。根治性前列腺切除术的人口增长率的增加和减少百分比约为其真实率的两倍。结论：基于所有Medicare受益人的前列腺癌根治术的发生率严重夸大了该程序使用的变化。在可能的情况下，在诊断和治疗程序，并发症和不良反应的研究中应使用以危险人群为分母的真实比率。

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