MCC Prostate Cancer Priority Review (Feb 18, 2004)MCC前列腺癌优先审查（2004年2月18日）.pptVIP

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MCC Prostate Cancer Priority Review (Feb 18, 2004)MCC前列腺癌优先审查（2004年2月18日）.ppt

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MCC Prostate Cancer Priority Review (Feb 18, 2004)MCC前列腺癌优先审查（2004年2月18日）

MCC Prostate Cancer PriorityReview Angela Fagerlin, PhD, David Rovner, MD, Richard Wimberley, MPA, Judith Suess, MD, MPH February 18, 2004 Outcomes for MCC Board members Awareness of unique characteristics of prostate cancer and resulting controversies Understanding of accomplishments, ongoing efforts and future work of Prostate Cancer Action Committee to implement prostate cancer priority Recommendations for focus in prostate cancer for next two years Prostate Cancer 101 Biologically heterogeneous with indolent and aggressive forms, e.g., die with the former, die of the latter. Contradicts usual meaning of “cancer” ~75-80% of autopsies +prostate cancer cells ACS projected figures for U.S. 2004: ~192.6/100K Incidence (I) and ~34.3/100K Mortality (M) from prostate cancer;?~18% (1 in 6) of men who get prostate cancer die of it Prostate Cancer 101 Screening at this time cannot differentiate indolent from early stage of aggressive form of prostate cancer Standard treatment of early disease does not decrease disease specific mortality and results in significant side effects—impotence, urinary incontinence, bowel incontinence—temporary or permanent Treatment of more advanced disease does save lives Prostate Cancer 101 Current Issues Obesity may be a factor in aggressiveness Racial disparity in prostate cancer care Use of new technologies to treat prostate cancer usually without compelling proof of benefit Laparoscopic radical prostatectomy Cryosurgery—considered standard treatment by minority Widespread use of alternative therapies for prostate cancer Prostate Cancer in Michigan Most commonly diagnosed form of cancer (other than skin cancer); 2nd leading cause of cancer mortality in men. All cause mortality 1,131.4/100K; mortality due to prostate cancer 32.6/100K?3 % mortality due to prostate cancer among Michigan men in 2001 Prostate Cancer in Michigan Mortality was increasing, peaked at 43/100,000 (/100K) in 1993; ↓ to 32.6/100K by 2001 Shift in stage at diagn