r survival probability. Methods: We conducted a retrospective cohort study using a nationally representative population of HD patients. Patients receiving HD each calendar year from 2003-2018, ≥1 year of Medicare as the Primary Payer, and age 50-69 years were included. The cohort was split into prognosis and cancer screening sets. Models of five-year survival were built in the prognosis set using logistic regression. Five-year survival probabilities were generated in the cancer screening set, excluding patients with prior breast or prostate cancer, and screening over the next year was assessed. Results: 160,537 patients contributed 356,165 person-years to the cancer screening set (59% of the person-years were contributed by males, median age was 60 years). Compared to a benchmark rate of 50% (e.g., mammography every other year), 42% of waitlisted female-years were screened by mammography. Overall, 17% of non-waitlisted female-years were screened (20% among those with >50% probability of five-year survival and 8% among those with <10% probability of five-year survival). Compared to a benchmark rate of 20% [e.g., serum prostate-specific antigen (PSA) screening up to five years apart], 24% of waitlisted male-years were screened with serum PSA. Overall 15% of non-waitlisted male-years were screened (13% among those with >50% probability of five-year survival and 1% among those with <10% probability of five-year survival). Patterns were similar after age-standardization. Conclusion: Patients with higher predicted survival have higher rates of cancer screening, suggesting providers consider life expectancy. However, non-waitlisted patients with high probability of five-year survival were less likely to be screened compared to waitlisted patients. Interventions may be needed to close this screening gap. Copyright © 2024 by the American Society of Nephrology...

中文翻译：

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按透析肾功能衰竭患者预期寿命进行乳腺癌和前列腺癌筛查


r 生存概率。方法： 我们使用具有全国代表性的 HD 患者群体进行了一项回顾性队列研究。包括 2003-2018 年每个日历年接受 HD 的患者，≥ 1 年的 Medicare 作为主要付款人，年龄 50-69 岁。该队列分为预后和癌症筛查组。使用 logistic 回归在预后集中构建 5 年生存模型。在癌症筛查集中生成五年生存概率，不包括既往患有乳腺癌或前列腺癌的患者，并评估了明年的筛查。结果：160,537 名患者为癌症筛查集贡献了 356,165 人年 （59% 的人年由男性贡献，中位年龄为 60 岁）。与 50% 的基准率（例如，每隔一年进行一次乳房 X 光检查）相比，42% 的等待名单女性年龄接受了乳房 X 光检查筛查。总体而言，筛查了 17% 的非候补名单女性年龄（5 年生存概率为 >50% 的人群为 20%，5 年生存概率为 <10% 的人群为 8%）。与 20% 的基准率相比 [例如，间隔长达 5 年的血清前列腺特异性抗原 （PSA） 筛查]，24% 的候补名单男性接受了血清 PSA 筛查。总体而言，筛查了 15% 的非候补名单男性年龄（在五年生存概率为 >50% 的患者中为 13%，在五年生存概率为 <10% 的患者中为 1%）。年龄标准化后模式相似。结论： 预测生存率较高的患者癌症筛查率较高，建议提供者考虑预期寿命。然而，与等待名单患者相比，具有 5 年生存概率高的非等待名单患者接受筛查的可能性较小。 可能需要干预措施来缩小这一筛查差距。美国肾脏病学会版权所有 © 2024...