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1、Importance of prostate cancer early mass screening using PSA PSA检测在前列腺癌早期筛查中的重要性 Shanghai Ailex Medicine Co Ltd Jiajun Qin 2009 08 Ao Lee Taiwan The prostate is part of the male reproductive system Its major function is to secrete a fluid to nourish semen during intercourse The prostate is about the
2、 size of a walnut but it can grow with age It is located below the urinary bladder in front of the rectum surrounding the urethra the canal for the discharge of urine that extends from the urinary bladder to the outside PCa Overview Prostate Cancer Bladder Prostate Gland Urethra It is a disordered a
3、nd abnormal cell growth In prostate cancer as in other types of cancer cells grow out of control and form tumors If the tumor is within the gland the cancer is said to be localized and curable If the cancer escapes the gland it is considered incurable PCa Prostate Cancer The incidence of PCa world w
4、ide age standardized The incidence of PCa world wide age standardized using the World Standard Populationusing the World Standard Population Quinn M and Babb P BJU International 2002 90 162 173 Quinn M and Babb P BJU International 2002 90 162 173 The international incidence of PCa age The internatio
5、nal incidence of PCa age standardized using World Standard Populationstandardized using World Standard Population Quinn M and Babb P BJU International 2002 90 162 173 Quinn M and Babb P BJU International 2002 90 162 173 Comparison of PCa s MR and IR Incidence Rate Mortality Rate MR IR World25 38 20
6、32 North America 119 915 80 13 Asia4 72 70 57 China1 6 1 0 0 63 J Clin Oncol 2006 24 2137 50 Morbidity and Mortality Rates of PCa Morbidity and Mortality Rates of PCa increase in Chinaincrease in China l In 1985 the age adjusted morbidity and mortality rates of PCa in Beijing were 2 41 and 1 19 100
7、000 males respectively l In 1995 they were 4 55 and 2 36 100 000 males respectively l In Beijing the morbidity rate of PCa has increased about 2 3 times from 1985 to 1995 Gu Fangliu Chinese J Urology 1997 18 1 58 62 Gu Fangliu Chinese J Urology 1997 18 1 58 62 Gu Fangliu J Practical Medicine 2000 16
8、 12 977 8 Gu Fangliu J Practical Medicine 2000 16 12 977 8 Du Shufa et al J Hygiene Research 1997 26 5 356 9 Du Shufa et al J Hygiene Research 1997 26 5 356 9 Standardized Incidences SI of PCa in Shanghai Standardized Incidences SI of PCa in Shanghai 1990 2000 1 100 000 1990 2000 1 100 000 Shao CX e
9、t al Chinese J Health Statistics 2005 32 321 Shao CX et al Chinese J Health Statistics 2005 32 321 Zhang W et al Chinese J Cancer 2004 23 555 Zhang W et al Chinese J Cancer 2004 23 555 Tumor 2003 23 6 532 Tumor 2003 23 6 532 Ranks of urological cancers among Top 10 male Ranks of urological cancers a
10、mong Top 10 male cancers in Shanghai 1998 2000 cancers in Shanghai 1998 2000 Cancer 1998 1999 2000 Cancer 1998 1999 2000 PCa 9 9 PCa 9 9 7 7 Bladder 7 7 8 Bladder 7 7 8 Kidney 10 10 10 Kidney 10 10 10 Shao CX et al Chinese J Health Statistics 2005 32 321 Shao CX et al Chinese J Health Statistics 200
11、5 32 321 Zhang W et al Chinese J Cancer 2004 23 555 Zhang W et al Chinese J Cancer 2004 23 555 Tumor 2003 23 6 532 Tumor 2003 23 6 532 Age adjusted incidence rates of PCa in China Age adjusted incidence rates of PCa in China from 1993 1997 from 1993 1997 Sim H G and Cheng C W S Eur J Cancer 2005 41
12、834 845 Sim H G and Cheng C W S Eur J Cancer 2005 41 834 845 Prostate cancer in Chinese migrantsProstate cancer in Chinese migrants Cook L S et al J Urol 1999 161 152 155 Cook L S et al J Urol 1999 161 152 155 Different Morbidity and Mortality among Chinese in Different Areas Chinese living in diffe
13、rent areas have quite different incidences of PCa with one higher than another by several times Factors Influencing Incidence of PCaFactors Influencing Incidence of PCa l lRacial differenceRacial difference l lEnviromental factorsEnviromental factors l lDietary intakeDietary intake Fat Fat Red Meat
14、Red Meat Vegetable Vegetable Soy Bean Soy Bean Causes for Low Incidence of PCa Causes for Low Incidence of PCa in Chinese Malesin Chinese Males l l As As major major constituent constituent of of Chinese Chinese diet diet Soy Soy products products contain contain high high quantities quantities of o
15、f Phyto Phyto estrogen that can suppress cancer growth estrogen that can suppress cancer growth l l Low Low fat fat and and low low animal animal meat meat in in traditional traditional Chinese foods Chinese foods l l Relatively Relatively longer longer CAG CAG polymorphic polymorphic repeat repeat
16、length length for for AR AR gene gene for for Chinese Chinese males males Shorter Shorter CAG CAG repeats repeats are are associated associated with with higher higher incidence and earlier onset of PCa incidence and earlier onset of PCa The PCa incidence of Chinese Really so low The PCa incidence of Chinese Really so low Reasons l The patients in early stage of prostate cancer do not see the doctor because of lacking symptoms l l Traditional Traditional digital digital rectal rectal examination
