Relación entre el uso del antígeno prostático específico y tratamiento de bloqueo androgénico.Un estudio ecológico

Abstract

Objective: To determine if a larger number of determinations of prostate-specific antigen (PSAn) is associated with an increased number of androgen deprivation therapies (ADTn). Study Design: Transversal ecological study. Setting: Primary care at provincial level. Participants: Permanent general practitioners with at least 1-year tenure. Main measurements: The number of men over 50 (V50) and their age, PSAn and ADTn in 2012 were determined for each family medicine quota in the region of Ourense (Spain). A sample size of 113 physicians was calculated. The association between ADTn and PSAn was analyzed by Spearman correlation. The ADTn was considered as a dependent variable in a multiple linear regression analysis, including as covariates gender of the physician, rural or urban context of work, V50, patient age and PSAn. A p value <0.05 was considered significant. Results: We studied 265 physicians, 54.1 % men. V50 average was 272.6 (SD 68.6), ADTn was 8.5 (4.0) per medical quota, and PSAn was 90.9 (52.4)/year. There was a relationship between the number of V50 and PSAn (Spearman´s Rho=0,4; CI95 %:0.3-0.7; p=0.01) and between ADTn and age of V50 (Spearman´s Rho=0.2; CI95 %:0.04-0.31; p<0.001). Association was found between ADTn and PSAn (Spearman´s Rho=0.2; CI95 %:0.04-0.31; p=0.01) and number of V50 and ADTn (Spearman´s Rho=0,5; CI95 %: 0,75-0,84; p<0.001). . Linear regression showed a relationship between ADTn and age of males (p<0.001) and number of V50 (p<0.001). Conclusion: A higher frequency of PSA testing does not follow from an increased diagnosis of PCa measured by the number of ADT, that is associated with the age and number of males over 50.