Geographical variation in incidence of prostate cancer in Sweden.
OBJECTIVE
To investigate the geographical variation in prostate cancer incidence in Sweden, in particular the incidences of screening-detected tumours and curative treatment of prostate cancer.


METHODS
Data were retrieved from the National Prostate Cancer Register of Sweden for all cases of prostate cancer diagnosed in the year 2000-01. There were a total of 14 376 cases of prostate cancer and the mean total annual age-adjusted incidence was 197/100 000 men. There were 3318 cases in tumour category T1c, i.e. non-palpable tumours diagnosed during work-up for an elevated serum level of prostate-specific antigen, 1006 of which (30%) were asymptomatic and detected at a health check-up.


RESULTS
The difference between the counties with the lowest and highest age-adjusted incidences per 100 000 men of total prostate cancer was almost twofold (128 vs 217). The corresponding variation in incidence of category T1c tumours was more than fourfold (13 vs 60); the difference in incidence of T1c tumours detected in asymptomatic men was up to 10-fold (2 vs 20); and there was more than a fourfold variation in incidence of curative treatment between counties (13 vs 67). Measured incidences were mostly highest in urban regions and in counties with university hospitals.


CONCLUSIONS
There are large geographical variations in prostate cancer incidence and in the frequency of curative treatment for prostate cancer in Sweden and there appear to be large geographical variations in the uptake of prostate cancer screening.
Stattin
Pär
P
Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University Hospital, Umeå, Sweden. par.stattin@urologi.umu.se
Johansson
Robert
R
Lodnert
Ronald
R
Andrén
Ove
O
Bill-Axelsson
Anna
A
Bratt
Ola
O
Damber
Jan-Erik
JE
Hellström
Magnus
M
Hugosson
Jonas
J
Lundgren
Rolf
R
Törnblom
Magnus
M
Varenhorst
Eberhard
E
Johansson
Jan-Erik
JE
D000368:Aged; D006801:Humans; D015994:Incidence; D008297:Male; D009367:Neoplasm Staging; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000453:epidemiology* / Q000473:pathology; D012189:Retrospective Studies; D012424:Rural Population; D013548:Sweden / Q000453:epidemiology; D014505:Urban Population
D017430:Prostate-Specific Antigen