RESUMO
BACKGROUND: Prostate cancer is one of the most common malignant tumors worldwide, and is the third-leading cause of cancer death in men. Nearly 70% of new prostate cancer patients in China are locally advanced or widely metastatic with poor prognosis. Providing active treatment to early stage prostate cancer patients can improve the prognosis of prostate cancer patients. Thus, this study sought to evaluate the economy of early prostate specific antigen (PSA) screening for high-risk prostate cancer. METHODS: Based on the data collected from the PSA screening activities of 11 county hospitals from October 2019 to April 2021, this study evaluated a high-risk prostate cancer population who received PSA screening and their quality of life and economy. The screening population comprised males aged over 50 years. All screening patients were tested for PSA. If the PSA value is unnormal, a further diagnosis based on magnetic resonance imagining (MRI) or a transrectal ultrasound-guided prostate biopsy were performed. The decision-tree and Markov model was used to simulate the process of disease development of high-risk prostate cancer patients who underwent screenings and those who did not, and the incremental cost-effectiveness ratio was also evaluated. RESULTS: A total of 13,726 men received a PSA screening. Of these, 1,062 men had abnormal PSA values, and 73 of these were diagnosed with prostate cancer. Of these 73 patients, 40, 21, and 12 had early stage, mid-stage, and late-stage prostate cancer, respectively. Compared to the patients unscreened, the 1,000 patients who received an early PSA screening increased their quality-adjusted life year (QALY) by 15.69 years; however, each QALY had an additional cost of 38,550 yuan, which was lower than the willingness to pay threshold of 72,447 yuan (per capita gross domestic product in 2020). CONCLUSIONS: For high-risk prostate cancer patients, early screenings have a cost-effective advantage over no screenings. Thus, early screening should be vigorously promoted for high-risk prostate cancer patients.
RESUMO
AIM: To analyze factors that affect the prognosis of triple-negative breast cancer patients under 35 years old. MATERIAL AND METHODS: We retrospectively analyzed confirmed triple-negative breast cancer cases from 2000 to 2016 in multiple institutions. A total of 105 patients were included in the study, Nineteen of them were diagnosed with age ≤ 25, and 86 of them were aged between 26 to 35. RESULT: There were no statistically significant differences in clinicopathologic features and treatment choices between patients aged ≤ 25 years and those aged 26-35 years (P > 0.05). Survival analysis showed no statistically significant differences in DFS and OS between the two groups (P > 0.05). Multiple factor analysis showed that age of menarche (HR 0.697, 95% CI [0.5634, 0.8631]), pregnancy correlation (HR 2.673, 95% CI [1.1581, 6.1741]), and lymph node positivity (HR 4.915, 95% CI [2.3774, 10.1627]) were independent prognostic factors that affected patients' DFS. Independent prognostic factors that influenced OS were age of menarche (HR 0.598, 95% CI [0.462 6, 0.775]) and lymph node positivity (HR 7.751, 95% CI [2.923, 20.559]). CONCLUSION: There was no difference in the clinicopathological features and prognosis between women ≤ 25 and women aged 26-35 years with triple-negative breast cancer. Age of menarche, pregnancy correlation, and positive lymph nodes were independent factors affecting prognosis. The relationship between reproductive factors and prognosis in young patients with triple-negative breast cancer needs further discussion.
