Introduction: Epidemiological data are crucial for adopting primary and secondary prevention strategies and to develop screening protocols against prostate cancer (PCa). Despite the comprehensive characterization of PCa across White and Black men, there is a lack of data from the Mexican population. This manuscript presents data from the Can.Prost registry that captures PCa trends over the past two decades in Mexico City; furthermore, we aimed to compare clinical differences and oncological outcomes before and after the promotion of early detection actions through a campaign against PCa that occurred in 2014. Methods: A retrospective observational study on newly diagnosed Mexican PCa patients was carried out at the Instituto Nacional de Cancerología (INCan) in Mexico City. During 2014 and 2015, a project for the early diagnosis of PCa (“OPUS program”) was launched in the aforementioned tertiary hospital. Starting at the age of 45 years, all men were invited for a PSA measurement and a specialist urologist consultation. All individuals with clinical or biochemical suspicion of PCa (PSA > 4 ng/mL), in the context of age and prostate volume, underwent ultrasound-guided transrectal prostate biopsy. Then, patients with pathologically confirmed prostate cancer were stratified according to the year of diagnosis: Group A accounted for those diagnosed between 2000 and 2014 and Group B for those patients diagnosed in the timeframe of 2015–2021. Comparisons of PCa characteristics, treatment modalities and oncologic outcomes between Group A and B were performed. Results: Overall, we collected data from 2759 PCa patients from 2000 to 2021. The median PSA at baseline was 32 ng/mL, and 25% had a family history of PCa. Overall, 25.8% were asymptomatic and 46% had a non-metastatic presentation. After the OPUS campaign, PSA at diagnosis was significantly lower across all age groups. The incidence of PCa diagnosis in asymptomatic men was higher (31.4% vs. 19.9%) and a higher proportion of men were diagnosed with organ-confined, palpable disease (46% vs. 28%) (p< 0.001). The rate of patients eligible for active/radical treatment was higher after the OPUS campaign (patients who received surgery increased from 12.78% to 32.41%; patients who underwent radiation increased from 28.38% to 49.61%). The proportion of patients diagnosed with non-clinically significant disease was negligible and remained stable across time. Conclusions: PCa in Mexican patients displays aggressive features at diagnosis, whereas the rate of non-significant disease is negligible. The introduction of early detection strategies may lead to lower symptomatic and metastatic PCa and higher opportunities for radical treatment. This emphasizes the need for public awareness and for adjustment of screening strategies to the peculiarities of the Mexican population.
引言：流行病学数据对于制定前列腺癌（PCa）的一级和二级预防策略以及建立筛查方案至关重要。尽管已对白人和黑人男性的PCa进行了全面特征描述，但墨西哥人群的数据仍较为缺乏。本文基于Can.Prost登记库，展示了墨西哥城过去二十年的PCa趋势数据；此外，我们旨在比较2014年开展的前列腺癌防治行动推动早期检测措施前后，患者临床特征及肿瘤学结局的差异。方法：在墨西哥城国家癌症研究所（INCan）对墨西哥新诊断PCa患者开展了一项回顾性观察研究。2014年至2015年间，该三级医院启动了PCa早期诊断项目（"OPUS计划"）。自45岁起，所有男性均被邀请进行PSA检测和泌尿专科医师咨询。所有根据年龄和前列腺体积存在临床或生化疑似PCa（PSA > 4 ng/mL）的个体均接受超声引导下经直肠前列腺穿刺活检。随后，将病理确诊的前列腺癌患者按诊断年份分层：A组为2000-2014年确诊患者，B组为2015-2021年确诊患者。比较两组患者的PCa特征、治疗模式及肿瘤学结局。结果：2000-2021年间共纳入2759例PCa患者。基线PSA中位数为32 ng/mL，25%有PCa家族史。总体而言，25.8%患者无症状，46%表现为非转移性疾病。OPUS计划实施后，所有年龄组的确诊PSA值均显著降低。无症状男性的PCa诊断率更高（31.4% vs. 19.9%），器官局限性可触及病变的确诊比例更高（46% vs. 28%）（p<0.001）。OPUS计划后符合积极/根治性治疗条件的患者比例更高（接受手术患者从12.78%增至32.41%；接受放疗患者从28.38%增至49.61%）。非临床显著性病变的诊断比例极低且保持稳定。结论：墨西哥PCa患者在诊断时即呈现侵袭性特征，而非显著性病变比例极低。早期检测策略的实施可能降低症状性和转移性PCa的发生率，并提高根治性治疗机会。这强调了提升公众认知度以及根据墨西哥人群特点调整筛查策略的必要性。
肿瘤(癌症)患者之家