Raadpleeg ook literatuurlijst niet-toxische middelen, voeding en behandelingen specifiek bij prostaatkanker van arts-bioloog drs. Engelbert Valstar.
Als donateur kunt u ook korting krijgen bij verschillende bedrijven, waaronder bij Medpro voor o.a. prostasol een veel gebruikt natuurlijk middel bij prostaatkanker als alternatief voor hormoontherapie, maar ook voor andere voedingssupplementen.
Zie ook dit artikel: https://kanker-actueel.nl/NL/regelmatige-psa-screening-vermindert-kans-op-sterven-aan-prostaatkankermet-bijna-de-helft-aldus-grote-langjarige-zweedse-bevolkingsstudie.html
9 december 2022: Bron: JAMA
Uit een grote langjarige cohortstudie van mannelijke patiënten uitgevoerd in de periode van 2005 (n = 4678412) tot 2019 (n = 5371701), en die werden gezien in 128 ziekenhuizen van de Amerikaanse Veterans Health Administration , hadden de ziekenhuizen die vaker een PSA - prostaatspecifieke antigeenscreening uitvoerden in vergelijking met ziekenhuizen die minder vaak een PSA screening deden jaren later beduidend minder patiënten met ernstige uitgezaaide prostaatkanker. Blijkbaar werkt een jaarlijkse PSA screening beter voor mannen in de leeftijd vanaf 40 jaar als preventie van uitgezaaide prostaatkanker zo stellen de onderzoekers. En vooral voor mannen die hoger risico lopen zou jaarlijks een PSA-meting zeker zinvol kunnen zijn, stelt Alex K. Bryant, M.D., hoofdauteur van de studie.
Uit het abstract vertaald:
De studie analyseerde de gegevens van 4678412 mannen in 2005 en 5371701 mannen in 2019. Prostaatspecifieke antigeenscreeningspercentages (PSA) daalden van 47,2% in 2005 tot 37,0% in 2019, en de incidentie van uitgezaaide prostaatkanker steeg van 5,2 per 100000 mannen in 2005 tot 7,9 per 100.000 mannen in 2019.
Hogere PSA-screeningspercentages op ziekenhuisniveau werden geassocieerd met een lagere incidentie van gemetastaseerde prostaatkanker 5 jaar later (incidence rate ratio , 0,91 per 10% toename in PSA-screeningspercentage; 95% CI, 0,87 -0,96; P < .001).
Hogere percentages zonder screening op lange termijn waren geassocieerd met een hogere incidentie van gemetastaseerde prostaatkanker 5 jaar later (IRR, 1,11 per 10% toename in percentage zonder screening op lange termijn; 95% CI, 1,03-1,19; P = .01).
"Deze studie levert het bewijs dat ziekenhuizen die mannen intensiever screenen, later het risico op uitgezaaide prostaatkanker kunnen verminderen", zegt Alex K. Bryant, M.D., hoofdauteur van de studie en arts in opleiding oncologie aan de Universiteit van Michigan Rogel Kankercentrum in Ann Arbor, Michigan.
Hoewel de studie geen gerandomiseerde, klinische studie was - de gouden standaard bij het begeleiden van de klinische praktijk - zijn de bevindingen gebaseerd op bewijs uit de echte wereld dat kan helpen bij het nemen van screeningsbeslissingen voor patiënten die individuele risico's en voordelen afwegen. "Als iemand een sterke familiegeschiedenis van prostaatkanker of andere risicofactoren had en zijn risico op uitgezaaide prostaatkanker wilde verminderen, zouden deze bevindingen de beslissing om te screenen kunnen ondersteunen," zei Dr. Bryant.
Bovenstaande is vertaling van gedeeltes uit een persbericht: https://www.rogelcancercenter.org/news/archive/lower-prostate-cancer-screening-rates-associated-subsequent-increase-advanced-cancers.
De studie zelf is gepubliceerd in JAMA en gratis in te zien of te downloaden. Klik op de titel van het abstract:
JAMA Oncol. Published online October 24, 2022. doi:10.1001/jamaoncol.2022.4319
Audio Author Interview (16:36)
Key Points
Question Are higher rates of prostate-specific antigen screening associated with lower population-level incidence of metastatic prostate cancer?
Findings In this cohort study of male patients seen at 128 US Veterans Health Administration facilities from 2005 (n = 4 678 412) to 2019 (n = 5 371 701), facilities with higher rates of prostate-specific antigen screening had lower subsequent metastatic prostate cancer incidence rates.
Meaning The findings suggest that variation in prostate cancer screening rates is associated with subsequent metastatic prostate cancer incidence; these data may inform shared decision-making about the potential benefits of prostate-specific antigen screening.
Importance There is controversy about the benefit of prostate-specific antigen (PSA) screening. Prostate-specific antigen screening rates have decreased since 2008 in the US, and the incidence of metastatic prostate cancer has increased. However, there is no direct epidemiologic evidence of a correlation between population PSA screening rates and subsequent metastatic prostate cancer rates.
Objective To assess whether facility-level variation in PSA screening rates is associated with subsequent facility-level metastatic prostate cancer incidence.
Design, Setting, and Participants This retrospective cohort used data for all men aged 40 years or older with an encounter at 128 facilities in the US Veterans Health Administration (VHA) from January 1, 2005, to December 31, 2019.
Exposures Yearly facility-level PSA screening rates, defined as the proportion of men aged 40 years or older with a PSA test in each year, and long-term nonscreening rates, defined as the proportion of men aged 40 years or older without a PSA test in the prior 3 years, from January 1, 2005, to December 31, 2014.
Main Outcomes and Measures The main outcomes were facility-level yearly counts of incident metastatic prostate cancer diagnoses and age-adjusted yearly metastatic prostate cancer incidence rates (per 100 000 men) 5 years after each PSA screening exposure year.
Results The cohort included 4 678 412 men in 2005 and 5 371 701 men in 2019. Prostate-specific antigen screening rates decreased from 47.2% in 2005 to 37.0% in 2019, and metastatic prostate cancer incidence increased from 5.2 per 100 000 men in 2005 to 7.9 per 100 000 men in 2019. Higher facility-level PSA screening rates were associated with lower metastatic prostate cancer incidence 5 years later (incidence rate ratio , 0.91 per 10% increase in PSA screening rate; 95% CI, 0.87-0.96; P < .001). Higher long-term nonscreening rates were associated with higher metastatic prostate cancer incidence 5 years later (IRR, 1.11 per 10% increase in long-term nonscreening rate; 95% CI, 1.03-1.19; P = .01).
Conclusions and Relevance From 2005 to 2019, PSA screening rates decreased in the national VHA system. Facilities with higher PSA screening rates had lower subsequent rates of metastatic prostate cancer. These data may be used to inform shared decision-making about the potential benefits of PSA screening among men who wish to reduce their risk of metastatic prostate cancer.
Accepted for Publication: July 27, 2022.
Published Online: October 24, 2022. doi:10.1001/jamaoncol.2022.4319
Corresponding Author: Brent S. Rose, MD, MAS, Department of Radiation and Applied Sciences, University of California, San Diego, Altman Clinical and Translational Research Institute Building, 9452 Medical Center Dr, La Jolla, CA 92037 (bsrose@ucsd.edu).
Author Contributions: Drs Bryant and Rose had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
Concept and design: Bryant, Murphy, DuVall, Lynch, Rose.
Acquisition, analysis, or interpretation of data: Bryant, Lee, Alba, Martinez, Natajaran, Green, Dess, Anglin-Foote, Robison, DuVall, Lynch, Rose.
Drafting of the manuscript: Bryant, Murphy, Rose.
Critical revision of the manuscript for important intellectual content: Bryant, Lee, Alba, Martinez, Natajaran, Green, Dess, Anglin-Foote, Robison, DuVall, Lynch, Rose.
Statistical analysis: Bryant, Alba, Murphy, Natajaran, Anglin-Foote, Rose.
Obtained funding: Lynch.
Administrative, technical, or material support: Lee, Alba, Anglin-Foote, Robison, DuVall, Lynch, Rose.
Supervision: Dess, DuVall, Lynch, Rose.
Conflict of Interest Disclosures: Dr Murphy reported receiving personal fees from Boston Consulting Group outside the submitted work. Dr Natajaran reported receiving grants from the US Department of Defense during the conduct of the study. Dr DuVall reported receiving grants from Alnylam Pharmaceuticals, Inc, Astellas Pharma, Inc, AstraZeneca Pharmaceuticals LP, Biodesix, Boehringer Ingelheim International GmbH, Celgene Corporation, Eli Lilly and Company, Genentech Inc, Gilead Sciences Inc, GlaxoSmithKline PLC, Innocrin Pharmaceuticals Inc, IQVIA Inc, Janssen Pharmaceuticals, Inc, Kantar Health, MDxHealth, Merck & Co, Inc, Myriad Genetic Laboratories, Inc, Novartis International AG, and Parexel International Corporation outside the submitted work. Dr Lynch reported receiving grants from the Department of Veterans Affairs Informatics and Computing Infrastructure during the conduct of the study and receiving grants from Alnylam Pharmaceuticals, Inc, Astellas Pharma, Inc, AstraZeneca Pharmaceuticals LP, Biodesix, Boehringer Ingelheim International GmbH, Celgene Corporation, Eli Lilly and Company, Genentech Inc, Gilead Sciences Inc, GlaxoSmithKline PLC, Innocrin Pharmaceuticals Inc, IQVIA Inc, Janssen Pharmaceuticals, Inc, Kantar Health, MDxHealth, Merck & Co, Inc, Myriad Genetic Laboratories, Inc, Novartis International AG, and Parexel International Corporation through the University of Utah or Western Institute for Veteran Research outside the submitted work. No other disclosures were reported.
Funding/Support: This work was supported using resources and facilities of the Department of Veterans Affairs Informatics and Computing Infrastructure (VINCI) through grant VA HSR RES 13-457.
Role of the Funder/Sponsors: VINCI staff were directly involved in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, and approval of the manuscript; and decision to submit the manuscript for publication.
Meeting Presentation: This paper was presented at the ASTRO Annual 2022 Meeting; October 24 and 25, 2022; San Antonio, Texas.
Additional Contributions: Ruth Etzioni, PhD (Program in Biostatistics, Fred Hutchinson Cancer Research Center, Seattle, Washington), provided valuable insights regarding statistical methods and was not compensated.
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preventie, prostaatkanker, PSA, screening, gevorderde ziekte, botuitzaaiingen
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