title: International comparison of the community prevalence of symptoms of prostatism in four countries.
abstract: We conducted an international comparison of the prevalence of urinary symptoms of prostatism in 4 countries, using a community-based random sampling of subjects, similar study procedures, and a single definition of cases that was based on a standardized symptom questionnaire. In Scotland 1,994 medically eligible men aged 40-79 years agreed to participate from 3 communities of the Forth Valley. In France, a nation-wide survey was conducted cross-sectionally in a representative sample of 2,011 French men aged 50-84 years. In the USA, the Olmsted County (OC) study recruited an age- and urban/rural-stratified random sample of 2,115 county residents drawn from medically eligible men aged 40-79 years. In Japan, 290 men aged 40-79 years from a fishing village participated in the study. Response rates were 55, 53, 55, and 43% in Scotland, France, OC and Japan, respectively. Urinary symptoms were assessed by the International Prostate Symptom Score (I-PSS), after metrologic validation in English and cross-cultural adaptation of the questionnaire. The prevalence of moderate to severe symptoms (I-PSS > 7) were 14, 18, 38, and 56% in France, Scotland, OC and Japan, respectively. This pattern was consistent within decades of age, and was found for most of the individual urinary symptoms. The proportion of men in Japan reporting very low I-PSS (0 or 1) was approximately 2, 4 and 8 times less frequent, than in OC, Scotland, and France, respectively. Differences in the prevalence of reported urinary symptoms might reflect between-country differences in the true prevalence of benign prostatic hyperplasia. However, cross-cultural differences in the perception and/or willingness to report urinary symptoms may play an important role in the observed differences. Further study will be required to elucidate the underlying causes of the observed differences.
authors.affiliation: Epidemiology Department Merck Research Laboratories, Paris, France.
authors.forename: P P
authors.initials: PP
authors.lastname: Sagnier
authors.forename: C J
authors.initials: CJ
authors.lastname: Girman
authors.forename: M
authors.initials: M
authors.lastname: Garraway
authors.forename: Y
authors.initials: Y
authors.lastname: Kumamoto
authors.forename: M M
authors.initials: MM
authors.lastname: Lieber
authors.forename: F
authors.initials: F
authors.lastname: Richard
authors.forename: G
authors.initials: G
authors.lastname: MacFarlane
authors.forename: H A
authors.initials: HA
authors.lastname: Guess
authors.forename: S J
authors.initials: SJ
authors.lastname: Jacobsen
authors.forename: T
authors.initials: T
authors.lastname: Tsukamoto
authors.forename: P
authors.initials: P
authors.lastname: Boyle
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D005602:France / Q000453:epidemiology; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D017430:Prostate-Specific Antigen / Q000097:blood; D011470:Prostatic Hyperplasia / Q000175:diagnosis / Q000453:epidemiology*; D011897:Random Allocation; D012606:Scotland / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
chemical_list: D017430:Prostate-Specific Antigen