中国前列腺癌的发病情况

ProstateCancerinChinaMingLiBeijingCancerHospital,PekingUniversityPCincidenceindifferentareaofChinainthreetimeperiods2023Shanghai21/100,000Beijing14/100,000PCIncidenceinDifferentCitiesandAreas0.02.04.06.08.010.012.014.01988-19921993-19971998-2023YearsIncidence(1/10万)北京市天津市上海市武汉市哈尔滨市磁县启东市嘉善县扶绥县长乐市林州市ProstateCancerIncidenceinChina0.001.002.003.004.005.006.00198819891990199119921993199419951996199719981999202320232023YearsIncidence(1/10万)Incidenceadjusted中国前列腺癌旳发病趋势LM,etcChinJUrol;2023,20(6):368-370(per100,000)57.7%41.1%中国前列腺癌发病率逐年上升中国前列腺癌旳发病率数据

（全国肿瘤登记，2023年）全国肿瘤登记地域2023年前列腺癌发病率为8.19/10万，中国标化率为3.90/10万。居男性全部恶性肿瘤第七位。2008中国肿瘤登记年报（ChineseCancerRegistryAnnualReport）-中国肿瘤登记地域2023年发病死亡.军事医学科学出版社，2009-9-1上海2023年肿瘤统计资料男性

11,195女性

9,55420% 乳腺11% 肺、支气管9% 结肠9% 胃5% 直肠5% 肝4% 卵巢 3% 中枢神经系统3% 子宫体3% 胰腺肺、支气管 21%胃 14%肝 10%结肠 8%前列腺 5%直肠 5%膀胱 4%胰腺 4% 食道 4%肾 3%上海市疾病预防控制中心上海前列腺癌标化发病率趋势上海市疾病预防控制中心2023年全国各大城市旳

前列腺癌发病率张思维,中国部分市县2023年恶性肿瘤发病年度报告.中国肿瘤,2007,16(7).

一线城市发病率较高PCIncidenceinDifferentCountriesandAreas1993-19972023-2023Theaveragelifespanincreasesto＞70yrsformale＞74yrsforfemale.

Thediagnostictechnologyimproved

PSA,BiopsytechniqueimprovedWesternizedfood.

ReasonsofPCIncidenceIncreasedTypicalChineseDietLowanimalmeat,ParticularredmeatLowfat,particularmeatoriginHighsoyproductsHighvegetablesHighcarbohydrateHighfiberTeaasthemostcommondrink

PCandDietStrongcorrelationbetweenfatconsumptionandmorbidityandmortalityofPC.American,30%-40%ofcaloriesfromfat.Meatsaremainsourcesofdietaryfat.Chinese,only11.5%ofcaloriesfromfat5.3%ofdietaryfatfrommeats.MoreandmoremeatandfatconsumptioninChinaChangesofFoodConsumptioninChina

(1952v1997)02468101214GRAINCOOKINGOILREDMEATAQUATICFOODPOULTRYEGGS19521997PCDiagnosisinChinaPSAng/mL PPVforcancer

0-1

2.8-5%

1-2.5

10.5-14%

2.5-4

22-30%

4-10

41%

>10

69%PSAvalueandriskofCaP＜4ng/ml18.1%PositiveDRE4-10ng/ml11.6%f/tPSA＞0.164-10ng/ml17.4%f/tPSA＜0.1610.1-20ng/ml26.2%＞20ng/ml61.7%DatafromEAUDatafromChinaMoreandmoreearlystagePChavebeendetectedPCstagechanges024681012141618201981-19901991-20232023-2023No-PSAwithPSAPSAscreeningAveragenumberofRPperyearPCinasingleinstituteNewcasesCUAGuidelineforPCPublishedin2023updatedin2023,2023GuidelineTraininginAlloverChinaToimprove:EarlydiagnosisReasonabletreatmentselectionsUnifytheopinionsCUAGuidelineforPCRecommendation:PSAtestandDREforthosewhoare＞50yearsoldandseedoctorsforLUTSorotherurinarysymptoms.PCscreeninginChina

ImpossibleforwholemalepopulationCUAGuidelineforPCBiopsyIndications:

PositiveDRE

PositiveUltrasoundorMRI

PSA＞10ng/ml

PSA4～10ng/mlwithf/tPSA＜1.6orPSAD＞0.15PCtreatmentinChina1980s:＜20%PCreceivedRP(localized)60-70%PCwithadvancedormetastasisdiseases2023s:20-40%PCundergoRP(localized)Around50%PCwithadvancedormetastasisdiseasesMorethan50%receivehormonaltherapyChangesofPCtreatmentoptionsPercentageofearlyPCisstilllow.PSAtestonlyforthosewhoareolderthan50yearsandseedoctorsforLUTSorotherurinarysymptoms.HormonalTherapy(＞50%):Inruralarea:＞80%surgicalcastrationInurbanarea:＞80%medicalcastrationRadicalProstatectomy(20～40%):In