Trends in incidence and mortality rates for prostate cancer before and after prostate-specific antigen introduction. A registry-based study in southeastern Netherlands, 1971-1995.
The incidence of prostate cancer has increased considerably over the past two decades, partly due to the increased detection of subclinical cases. In southeastern Netherlands, a region of almost 1 million inhabitants with good access to specialised medical care, prostate-specific antigen (PSA) assays were not introduced until 1990, allowing us to investigate the nature of the increases in incidence. Age-adjusted (European Standardised Rate) and age-specific rates were calculated using incidence data from the population-based Eindhoven Cancer Registry and mortality data from Statistics Netherlands. The age-adjusted incidence, which increased from 36 per 100,000 in 1971 to 55 per 100,000 in 1989, included all grades as well as metastasised prostate cancer. The age-adjusted mortality mainly fluctuated in this period, but increased among men aged 55-64 years from 12 per 100,000 in 1980 to 25 per 100,000 in 1989. After 1990, the age-adjusted incidence further increased to 80 per 100,000 in 1995, the increase representing mainly low-grade localised prostate cancer, presumably due to increasing opportunistic PSA testing, especially after 1993. A real increase in incidence may have occurred before 1993. However, pending results of randomised trials, judicious application of PSA testing seems justifiable to avoid unnecessary intervention without reducing mortality.
Post
P N
PN
Comprehensive Cancer Centre South (IKZ), Eindhoven, The Netherlands.
Kil
P J
PJ
Crommelin
M A
MA
Schapers
R F
RF
Coebergh
J W
JW
D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D015994:Incidence; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D017430:Prostate-Specific Antigen / Q000097:blood*; D011468:Prostatectomy / Q000379:methods / Q000401:mortality; D011471:Prostatic Neoplasms / Q000097:blood* / Q000401:mortality*; D012042:Registries
D017430:Prostate-Specific Antigen