Abstract：
OBJECTIVE: To analyze the generalizability of the Göteborg-2 findings to a North American cohort.
METHODS: We replicated the Göteborg-2 inclusion criteria in our Henry Ford Health (HFH) cohort, by identifying all patients 50-60 years old who had a PSA test from 2013 to 2018. The first PSA within the study period was considered PSA at entry, and included in the analysis. Chi-square test was used to compare categorical variables between the Göteborg-2 and HFH cohort, with a particular focus on Black men, who were also analyzed separately.
RESULTS: The HFH patients included in the cohort were 49 456, of which 8562 were Black. In patients within the entire HFH cohort, HFH Black cohort, Göteborg Reference cohort, and Göteborg Experimental cohort, the rate of PSA ≥3 ng/mL was, respectively, 6.8%, 10.2%, 6.8%, and 6.6%. The rate of biopsy performed was, respectively, 1.8%, 4.1%, 5.8%, and 2.5%. PCa was found in, respectively, 1.4%, 3.0%, 2.3%, and 1.5%; Gleason score 3 + 3 in, respectively, 0.5%, 0.8%, 1.2%, and 0.6%; Gleason score > 3 + 3 in, respectively, 0.9%, 2.2%, 1.1%, and 0.9%.
CONCLUSIONS: Our cohort had a lower biopsy rate and a lower incidence of non-csPCa diagnosis than both Göteborg cohorts, while still maintaining the same incidence of csPCa. This implies that the benefits of reducing non-csPCa diagnosis, as observed in the Experimental Göteborg cohort, are not necessarily replicable in U.S. \"real-world practice\" patients. Also noteworthy, we had a significantly higher percentage of Black men, who showed more aggressive disease.
METHODS: We replicated the Göteborg-2 inclusion criteria in our Henry Ford Health (HFH) cohort, by identifying all patients 50-60 years old who had a PSA test from 2013 to 2018. The first PSA within the study period was considered PSA at entry, and included in the analysis. Chi-square test was used to compare categorical variables between the Göteborg-2 and HFH cohort, with a particular focus on Black men, who were also analyzed separately.
RESULTS: The HFH patients included in the cohort were 49 456, of which 8562 were Black. In patients within the entire HFH cohort, HFH Black cohort, Göteborg Reference cohort, and Göteborg Experimental cohort, the rate of PSA ≥3 ng/mL was, respectively, 6.8%, 10.2%, 6.8%, and 6.6%. The rate of biopsy performed was, respectively, 1.8%, 4.1%, 5.8%, and 2.5%. PCa was found in, respectively, 1.4%, 3.0%, 2.3%, and 1.5%; Gleason score 3 + 3 in, respectively, 0.5%, 0.8%, 1.2%, and 0.6%; Gleason score > 3 + 3 in, respectively, 0.9%, 2.2%, 1.1%, and 0.9%.
CONCLUSIONS: Our cohort had a lower biopsy rate and a lower incidence of non-csPCa diagnosis than both Göteborg cohorts, while still maintaining the same incidence of csPCa. This implies that the benefits of reducing non-csPCa diagnosis, as observed in the Experimental Göteborg cohort, are not necessarily replicable in U.S. \"real-world practice\" patients. Also noteworthy, we had a significantly higher percentage of Black men, who showed more aggressive disease.
摘要：
目的：分析哥德堡-2研究结果在北美队列中的普遍性。
方法：我们在亨利·福特健康（HFH）队列中复制了哥德堡-2纳入标准，通过识别2013年至2018年进行PSA测试的所有50-60岁患者。研究期内的第一个PSA在进入时被认为是PSA，并包括在分析中。卡方检验用于比较哥德堡-2和HFH队列之间的分类变量，特别关注黑人，他们也被单独分析。
结果：纳入队列的HFH患者为49456例，其中8562例为黑人。在整个HFH队列中的患者中，HFH黑色队列，哥德堡参考队列,和哥德堡实验队列，PSA≥3ng/mL的比率为，分别,6.8%,10.2%,6.8%,和6.6%。活检率是，分别,1.8%,4.1%,5.8%,和2.5%。PCa被发现,分别,1.4%,3.0%,2.3%,和1.5%；格里森评分3+3英寸，分别,0.5%,0.8%,1.2%,和0.6%；格里森得分>3+3英寸，分别,0.9%，2.2%,1.1%,和0.9%。
结论：我们的队列与哥德堡队列相比，活检率更低，非csPCa诊断的发生率更低，同时仍然保持相同的csPCa发病率。这意味着减少非csPCa诊断的好处，正如在哥德堡实验队列中观察到的那样，在美国“现实世界的实践”患者中不一定可以复制。同样值得注意的是，我们的黑人比例明显更高，表现出更具侵略性的疾病。
方法：我们在亨利·福特健康（HFH）队列中复制了哥德堡-2纳入标准，通过识别2013年至2018年进行PSA测试的所有50-60岁患者。研究期内的第一个PSA在进入时被认为是PSA，并包括在分析中。卡方检验用于比较哥德堡-2和HFH队列之间的分类变量，特别关注黑人，他们也被单独分析。
结果：纳入队列的HFH患者为49456例，其中8562例为黑人。在整个HFH队列中的患者中，HFH黑色队列，哥德堡参考队列,和哥德堡实验队列，PSA≥3ng/mL的比率为，分别,6.8%,10.2%,6.8%,和6.6%。活检率是，分别,1.8%,4.1%,5.8%,和2.5%。PCa被发现,分别,1.4%,3.0%,2.3%,和1.5%；格里森评分3+3英寸，分别,0.5%,0.8%,1.2%,和0.6%；格里森得分>3+3英寸，分别,0.9%，2.2%,1.1%,和0.9%。
结论：我们的队列与哥德堡队列相比，活检率更低，非csPCa诊断的发生率更低，同时仍然保持相同的csPCa发病率。这意味着减少非csPCa诊断的好处，正如在哥德堡实验队列中观察到的那样，在美国“现实世界的实践”患者中不一定可以复制。同样值得注意的是，我们的黑人比例明显更高，表现出更具侵略性的疾病。
