title: Clinical characteristics and primary treatment of prostate cancer in Sweden between 1996 and 2005.
abstract: OBJECTIVE
  The incidence of prostate cancer is rising rapidly in Sweden and there is a need to better understand the pattern of diagnosis, tumor characteristics and treatment.
  
  
  METHODS
  Between 1996 and 2005, all new cases of adenocarcinoma of the prostate gland were intended to be registered in the National Prostate Cancer Register (NPCR). This register contains information on diagnosing unit, date of diagnosis, cause of diagnosis, tumor grade, tumor stage according to the TNM classification in force, serum prostate-specific antigen (PSA) levels at diagnosis and primary treatment given within the first 6 months after diagnosis.
  
  
  RESULTS
  In total, 72,028 patients were registered, comprising >97% of all pertinent incident cases of prostate cancer in the Swedish Cancer Register (SCR). During the study period there was a considerable decrease in median age at the time of diagnosis, a stage migration towards smaller tumors, a decrease in median serum PSA values at diagnosis, a decrease in the age-standardized incidence rate of men diagnosed with distant metastases or with a PSA level of > 100 ng/ml at diagnosis and an increase in the proportion of tumors with Gleason score <6. Relatively large geographical differences in the median age at diagnosis and the age-standardized incidence of cases with category T1c tumors were observed. Treatment with curative intent increased dramatically and treatment patterns varied according to geographical region. In men with localized tumors and a PSA level of <20 ng/ml at diagnosis, expectant treatment was more commonly used in those aged > or =75 years than in those aged <75 years. Also, the pattern of endocrine treatment varied in different parts of Sweden.
  
  
  CONCLUSIONS
  All changes in the register seen over time are consistent with increased diagnostic activity, especially PSA testing, resulting in an increased number of cases with early disease, predominantly tumors in category T1c. The patterns of diagnosis and treatment of prostate cancer vary considerably in different parts of Sweden. The NPCR continues to be an important source for research, epidemiological surveillance of the incidence, diagnosis and treatment of prostate cancer.
authors.affiliation: Oncological Centre, Karolinska University Hospital, CLINTEC, Karolinska Institute, Stockholm, Sweden. jan.adolfsson@karolinska.se
authors.forename: Jan
authors.initials: J
authors.lastname: Adolfsson
authors.forename: Hans
authors.initials: H
authors.lastname: Garmo
authors.forename: Eberhard
authors.initials: E
authors.lastname: Varenhorst
authors.forename: Göran
authors.initials: G
authors.lastname: Ahlgren
authors.forename: Christer
authors.initials: C
authors.lastname: Ahlstrand
authors.forename: Ove
authors.initials: O
authors.lastname: Andrén
authors.forename: Anna
authors.initials: A
authors.lastname: Bill-Axelson
authors.forename: Ola
authors.initials: O
authors.lastname: Bratt
authors.forename: Jan-Erik
authors.initials: JE
authors.lastname: Damber
authors.forename: Karin
authors.initials: K
authors.lastname: Hellström
authors.forename: Magnus
authors.initials: M
authors.lastname: Hellström
authors.forename: Erik
authors.initials: E
authors.lastname: Holmberg
authors.forename: Lars
authors.initials: L
authors.lastname: Holmberg
authors.forename: Jonas
authors.initials: J
authors.lastname: Hugosson
authors.forename: Jan-Erik
authors.initials: JE
authors.lastname: Johansson
authors.forename: Bill
authors.initials: B
authors.lastname: Petterson
authors.forename: Magnus
authors.initials: M
authors.lastname: Törnblom
authors.forename: Anders
authors.initials: A
authors.lastname: Widmark
authors.forename: Pär
authors.initials: P
authors.lastname: Stattin
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D012042:Registries; D012189:Retrospective Studies; D013548:Sweden
chemical_list: D017430:Prostate-Specific Antigen