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Article: The Impact of Prostate-Specific Antigen Screening on Prostate Cancer Incidence and Mortality in China: 13-Year Prospective Population-Based Cohort Study

TitleThe Impact of Prostate-Specific Antigen Screening on Prostate Cancer Incidence and Mortality in China: 13-Year Prospective Population-Based Cohort Study
Authors
KeywordsChina
cohort study
electronic health record
incidence
mortality
prostate cancer
prostate screening
prostate-specific antigen
PSA
screening interval
Issue Date18-Jan-2024
PublisherJMIR Publications
Citation
JMIR Public Health and Surveillance, 2024, v. 10, p. e47161 How to Cite?
Abstract

Background:The status of prostate-specific antigen (PSA) screening is unclear in China. Evidence regarding the optimal frequency and interval of serial screening for prostate cancer (PCa) is disputable.

Objective:This study aimed to depict the status of PSA screening and to explore the optimal screening frequency for PCa in China.

Methods:A 13-year prospective cohort study was conducted using the Chinese Electronic Health Records Research in Yinzhou study’s data set. A total of 420,941 male participants aged ≥45 years were included between January 2009 and June 2022. Diagnosis of PCa, cancer-specific death, and all-cause death were obtained from the electronic health records and vital statistic system. Hazard ratios (HRs) with 95% CIs were estimated using Cox regression analysis.

Results:The cumulative rate of ever PSA testing was 17.9% with an average annual percent change (AAPC) of 8.7% (95% CI 3.6%-14.0%) in the past decade in China. People with an older age, a higher BMI, higher waist circumference, tobacco smoking and alcohol drinking behaviors, higher level of physical activity, medication use, and comorbidities were more likely to receive PSA screening, whereas those with a lower education level and a widowed status were less likely to receive the test. People receiving serial screening ≥3 times were at a 67% higher risk of PCa detection (HR 1.67; 95% CI 1.48-1.88) but a 64% lower risk of PCa-specific mortality (HR 0.36; 95% CI 0.18-0.70) and a 28% lower risk of overall mortality (HR 0.72; 95% CI 0.67-0.77). People following a serial screening strategy at least once every 4 years were at a 25% higher risk of PCa detection (HR 1.25; 95% CI 1.13-1.36) but 70% (HR 0.30; 95% CI 0.16-0.57) and 23% (HR 0.77; 95% CI 0.73-0.82) lower risks of PCa-specific and all-cause mortality, respectively.

Conclusions:This study reveals a low coverage of PSA screening in China and provides the first evidence of its benefits in the general Chinese population. The findings of this study indicate that receiving serial screening at least once every 4 years is beneficial for overall and PCa-specific survival. Further studies based on a nationwide population and with long-term follow-up are warranted to identify the optimal screening interval in China.


Persistent Identifierhttp://hdl.handle.net/10722/340227
ISSN
2023 Impact Factor: 3.5
2023 SCImago Journal Rankings: 1.421
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorRuan, Xiaohao-
dc.contributor.authorZhang, Ning-
dc.contributor.authorWang, Dawei-
dc.contributor.authorHuang, Jingyi-
dc.contributor.authorHuang, Jinlun-
dc.contributor.authorHuang, Da-
dc.contributor.authorChun, Tsun Tsun Stacia-
dc.contributor.authorHo, Brian Sze Ho-
dc.contributor.authorNg, Ada Tsui-Lin-
dc.contributor.authorTsu, James Hok-Leung-
dc.contributor.authorZhan, Yongle-
dc.contributor.authorNa, Rong-
dc.date.accessioned2024-03-11T10:42:37Z-
dc.date.available2024-03-11T10:42:37Z-
dc.date.issued2024-01-18-
dc.identifier.citationJMIR Public Health and Surveillance, 2024, v. 10, p. e47161-
dc.identifier.issn2369-2960-
dc.identifier.urihttp://hdl.handle.net/10722/340227-
dc.description.abstract<p>Background:The status of prostate-specific antigen (PSA) screening is unclear in China. Evidence regarding the optimal frequency and interval of serial screening for prostate cancer (PCa) is disputable.</p><p>Objective:This study aimed to depict the status of PSA screening and to explore the optimal screening frequency for PCa in China.</p><p>Methods:A 13-year prospective cohort study was conducted using the Chinese Electronic Health Records Research in Yinzhou study’s data set. A total of 420,941 male participants aged ≥45 years were included between January 2009 and June 2022. Diagnosis of PCa, cancer-specific death, and all-cause death were obtained from the electronic health records and vital statistic system. Hazard ratios (HRs) with 95% CIs were estimated using Cox regression analysis.</p><p>Results:The cumulative rate of ever PSA testing was 17.9% with an average annual percent change (AAPC) of 8.7% (95% CI 3.6%-14.0%) in the past decade in China. People with an older age, a higher BMI, higher waist circumference, tobacco smoking and alcohol drinking behaviors, higher level of physical activity, medication use, and comorbidities were more likely to receive PSA screening, whereas those with a lower education level and a widowed status were less likely to receive the test. People receiving serial screening ≥3 times were at a 67% higher risk of PCa detection (HR 1.67; 95% CI 1.48-1.88) but a 64% lower risk of PCa-specific mortality (HR 0.36; 95% CI 0.18-0.70) and a 28% lower risk of overall mortality (HR 0.72; 95% CI 0.67-0.77). People following a serial screening strategy at least once every 4 years were at a 25% higher risk of PCa detection (HR 1.25; 95% CI 1.13-1.36) but 70% (HR 0.30; 95% CI 0.16-0.57) and 23% (HR 0.77; 95% CI 0.73-0.82) lower risks of PCa-specific and all-cause mortality, respectively.</p><p>Conclusions:This study reveals a low coverage of PSA screening in China and provides the first evidence of its benefits in the general Chinese population. The findings of this study indicate that receiving serial screening at least once every 4 years is beneficial for overall and PCa-specific survival. Further studies based on a nationwide population and with long-term follow-up are warranted to identify the optimal screening interval in China.</p>-
dc.languageeng-
dc.publisherJMIR Publications-
dc.relation.ispartofJMIR Public Health and Surveillance-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectChina-
dc.subjectcohort study-
dc.subjectelectronic health record-
dc.subjectincidence-
dc.subjectmortality-
dc.subjectprostate cancer-
dc.subjectprostate screening-
dc.subjectprostate-specific antigen-
dc.subjectPSA-
dc.subjectscreening interval-
dc.titleThe Impact of Prostate-Specific Antigen Screening on Prostate Cancer Incidence and Mortality in China: 13-Year Prospective Population-Based Cohort Study-
dc.typeArticle-
dc.identifier.doi10.2196/47161-
dc.identifier.scopuseid_2-s2.0-85182792347-
dc.identifier.volume10-
dc.identifier.spagee47161-
dc.identifier.eissn2369-2960-
dc.identifier.isiWOS:001166056100002-
dc.identifier.issnl2369-2960-

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