Prostate carcinoma trends in three counties in Sweden 1987-1996: results from a population-based national cancer register. South-East Region Prostate Cancer Group.
BACKGROUND
To detect changes in the incidence rate and management of prostate carcinoma, all cases of the disease diagnosed in the southeast region of Sweden between 1987-1996 were recorded.


METHODS
The register is based on Swedish personal registration numbers, thereby minimizing the number of dropouts. All cases of prostate carcinoma detected in the southeast region have been recorded according to a defined protocol that has been updated successively to match recent views regarding the disease. To ensure a high number of presented cases, the National Cancer Register was checked for missing cases.


RESULTS
Six thousand seven hundred eighty-two cases of prostate carcinoma were registered in the region between 1987-1996. The age-adjusted incidence rate reached a peak in 1993, followed by a slight decrease. The mean age at diagnosis throughout the period was 74.2 years, with a peak age of 74.8 years in 1992. The number of incidental tumors followed the development of the number of transurethral resections of the prostate performed in the region, with a peak in 1991. The percentage of patients receiving gonadotropin-releasing hormone (GnRH) analogues increased from 3.9% to 37.8% whereas the percentage of patients treated with orchiectomy decreased from 40.0% to 12.8% and the percentage of those treated with radical prostatectomy decreased from 11.1% to 2.5%.


CONCLUSIONS
A diminishing pool of latent tumors may explain the decreasing incidence rate and lower age at diagnosis observed after 1993. Orchiectomy is rapidly being superseded by GnRH analogues. In contrast to trends reported in the U.S., the percentage of men with prostate carcinoma undergoing total prostatectomy appears to be declining in Sweden.
Sandblom
G
G
Department of Urology, Faculty of Health Sciences, University Hospital of Linköping, Linköping, Sweden.
Dufmats
M
M
Nordenskjöld
K
K
Varenhorst
E
E
D000367:Age Factors; D000368:Aged; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D002277:Carcinoma / Q000453:epidemiology*; D015331:Cohort Studies; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D009367:Neoplasm Staging; D009919:Orchiectomy / Q000706:statistics & numerical data; D011159:Population Surveillance; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000032:analysis; D011468:Prostatectomy / Q000706:statistics & numerical data; D011470:Prostatic Hyperplasia / Q000453:epidemiology; D011471:Prostatic Neoplasms / Q000453:epidemiology*; D012042:Registries; D013548:Sweden / Q000453:epidemiology; D020728:Transurethral Resection of Prostate / Q000706:statistics & numerical data
D018931:Antineoplastic Agents, Hormonal; D007987:Gonadotropin-Releasing Hormone; D017430:Prostate-Specific Antigen