Impact of U.S. Preventative Services Task Force grade D recommendation against prostate-specific antigen screening on prostate cancer mortality.
Notice bibliographique
Résumé
51 Background: The U. S. Preventative Services Task Force (USPSTF) recommendation regarding prostate-specific antigen (PSA) transitioned to a grade D recommendation against PSA screening for adult males in 2012. The impact of this recommendation against PSA screening on prostate cancer-specific mortality (PCSM) in contemporary cohorts is unknown. Our study evaluated PCSM between 1999-2019, comparing mortality rates before and after this change to screening guidelines. Methods: Age-adjusted PCSM rates per 100,000 men were obtained from the National Center for Health Statistics from 1999 – 2019. Trends in PCSM rates from 1999 – 2012 and 2014 – 2019 were estimated using linear regression with year and binary indicator of pre-2013/post-2013 status as interaction terms. Age-adjusted rates of PCSM were calculated for men ≥50 years and by race, ethnicity, urbanization and census region. Similarly, age-adjusted rates of overall cancer mortality (exclusive of PCSM) were calculated. Behavioral Risk Factor Surveillance System was used to establish trends in PSA screening from 2001 – 2018. North American Association of Central Cancer Registries was used to determine age-adjusted incidence of localized and metastatic PC at the time of diagnosis from 1999 – 2017. Results: The age-adjusted PCSM rate in the U.S. decreased linearly at a rate of (-)0.28 per 100,000/year from 1999 – 2012 and subsequently stalled at a rate of no change from 2014 – 2019 (p < 0.001). This effect was particularly striking for men aged 60 – 69, men > 80 years, and Black men. Men aged 60 – 64 had a decreasing rate of (-)0.009 per 100,000/year prior to 2013, followed by a rise of (+)0.001 per 100,000/year (p < 0.001). Among Black men, PCSM rate was decreasing linearly at (-)0.700/100,000/year from 1999-2012 and flattened at a rate of (-)0.091/100,000/year from 2014-2019 (p < 0.001). These changes were seen across races, urbanization and census regions (p < 0.001) and were accompanied by decreases in PSA screening (p = 0.02) together with increases in diagnosis of metastatic disease. These trends were inconsistent with mortality trends observed across all malignancies. Conclusions: Using comprehensive data on PCSM through 2019, this study illustrates decreasing PCSM over time which flattened or increased following the 2012 change in USPSTF guideline, along with a decrease in PSA screening. The change in PCSM was seen in all ages, races, ethnicities, urbanization and census regions, but particularly in men from 60 – 69 and > 80 years old, and Black men. These changes were accompanied by increased diagnosis of metastatic PC and are discordant from trends across other malignancies. These findings suggest that the change in PSA screening guideline may have contributed to the stagnancy of PCSM rates in recent years. The updated 2018 USPSTF guideline supporting shared-decision making may reverse these trends over time.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,019 | 0,053 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,003 |
| Bibliométrie | 0,004 | 0,004 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,002 | 0,001 |
| Science ouverte | 0,002 | 0,002 |
| Intégrité de la recherche | 0,003 | 0,003 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,005 | 0,002 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».