title: Prostate cancer treatment in Europe at the end of 1990s.
abstract: BACKGROUND
  There is wide variation in prostate cancer incidence and survival across Europe. In many countries incidence is rising sharply in relation to the introduction of prostate-specific antigen assay, and there is concern that patients may not be treated appropriately. We therefore aimed to characterize treatment for prostate cancer across Europe.
  
  
  METHODS
  We performed a high resolution population-based study, collecting information on the treatment of 3 486 prostate cancer cases diagnosed in 1995-1999 in 11 cancer registries from six European countries.
  
  
  RESULTS
  Overall, about one in three patients received radical treatment (prostatectomy 23% or radiotherapy 14%); about 60% of younger patients (<70 years) received radical treatment, while a similar proportion of older patients (> or =70 years) received palliation (transurethral prostatectomy or hormone treatment only). A considerable proportion (61%) of patients with apparently high-risk disease were treated radically within a year of diagnosis, with large variation between regions: >70% in Calvados, Haut-Rhin, Tarn and Eindhoven and <50% in Slovakia and Cracow. Overall 34% of patients with apparently low-risk disease received radical treatment, varying from 17% and 22% in Bas-Rhin and Granada, to 52% and 56% in Calvados and Eindhoven.
  
  
  CONCLUSIONS
  Our data indicate wide variation in the treatment for prostate cancer even among patients with apparently similar disease, and further suggest a non-negligible proportion may be receiving inappropriate radical treatment for apparently low-risk disease. Current guidelines indicate active surveillance should become the main means of managing low-risk disease.
authors.affiliation: Evaluative Epidemiology Unit, Fondazione IRCCS, Istituto Nazionale Tumori, Milan, Italy. gemma.gatta@istitutotumori.mi.it
authors.forename: Gemma
authors.initials: G
authors.lastname: Gatta
authors.forename: Giulia
authors.initials: G
authors.lastname: Zigon
authors.forename: Antoine
authors.initials: A
authors.lastname: Buemi
authors.forename: Jan Willem
authors.initials: JW
authors.lastname: Coebergh
authors.forename: Marc
authors.initials: M
authors.lastname: Colonna
authors.forename: Paolo
authors.initials: P
authors.lastname: Contiero
authors.forename: Louis
authors.initials: L
authors.lastname: Denis
authors.forename: Pascale
authors.initials: P
authors.lastname: Grosclaude
authors.forename: Ann Valèrie
authors.initials: AV
authors.lastname: Guizard
authors.forename: Maria Jose
authors.initials: MJ
authors.lastname: Sanchez-Perez
authors.forename: Ivan
authors.initials: I
authors.lastname: Plesko
authors.forename: Martina
authors.initials: M
authors.lastname: Ondrusova
authors.forename: Jadwiga
authors.initials: J
authors.lastname: Rachtan
authors.forename: Riccardo
authors.initials: R
authors.lastname: Valdagni
authors.forename: Michael
authors.initials: M
authors.lastname: Velten
authors.forename: Marina
authors.initials: M
authors.lastname: Vercelli
authors.forename: Franco
authors.initials: F
authors.lastname: Berrino
mesh_terms: D000367:Age Factors; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D005060:Europe / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000453:epidemiology / Q000628:therapy*; D011878:Radiotherapy; D012042:Registries