The prostate cancer conundrum revisited: Treatment changes and prostate cancer mortality declines

Rákkutatás · Prostate cancer

Changes in primary treatment explain a minority of the observed decline in prostate cancer mortality.

Prostate cancer mortality in the United States fell by over 40 % between 1991 and 2005, yet the relative contributions of PSA screening, advances in early‑stage treatment, and other practice changes remain unclear. Using three independent simulation models calibrated to SEER incidence and treatment patterns, we estimated the fraction of the mortality decline attributable to changes in primary treatment (radical prostatectomy, radiation therapy, and androgen‑deprivation therapy). Across all models, primary treatment changes accounted for only 22–33 % of the observed decline by 2005 (16–23 % in older men). The remainder of the decline is likely due to PSA screening and improvements in the care of recurrent or progressive disease.

Quantifying how much of the prostate cancer mortality decline is driven by treatment advances versus other interventions—such as screening—helps clinicians and policymakers prioritise future research, screening protocols, and resource allocation. It also clarifies the degree of benefit that can realistically be expected from improvements in primary treatment modalities.

Bizonyítékszint: Korai humán adat. Kis vagy feltáró emberi adat.

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