title: Differences in survival from prostate cancer in Denmark, Iceland and Sweden.
abstract: BACKGROUND
  Register-based studies have shown large survival differences among prostate cancer patients in the Nordic countries. The aim of this study was to determine the background of such differences in Denmark, Iceland and Sweden.
  
  
  METHODS
  Patients with prostate cancer were identified through population-based cancer registers in the three countries. Clinical findings at diagnosis were retrieved from hospital records. In Sweden, clinical information was gathered from regional population-based prostate cancer registers. Country-specific incidence and excess mortality rates were compared, with adjustment for prognostic factors.
  
  
  RESULTS
  The relative survival in the cohorts was comparable to that in previous population-based studies. Significant differences in excess mortality rates were found across countries, which diminished or disappeared after adjustment for patient characteristics, i.e. metastatic status, clinical T stage and prostate-specific antigen level. A difference in the proportion of patients with metastatic disease was the main explanation of the differences in survival among countries, while the incidence rates of metastatic cancer were similar.
  
  
  CONCLUSIONS
  Register-based studies of the relative survival of prostate cancer patients are influenced by national differences in clinical presentation at diagnosis. Differences in the proportion of patients with metastatic spread explained most of the difference in relative survival among patients in Denmark, Iceland and Sweden. Future country comparisons of relative survival should include adjustment for differences in patient characteristics, such as stage, prostate-specific antigen level and screening intensity.
authors: Urological Research Unit, Department of Urology, Rigshospitalet, University of Copenhagen, Denmark. klausbrasso@hotmail.com
authors: Klaus
authors: K
authors: Brasso
authors: Inga Jóna
authors: IJ
authors: Ingimarsdóttir
authors: Ea
authors: E
authors: Rusch
authors: Gerda
authors: G
authors: Engholm
authors: Jan
authors: J
authors: Adolfsson
authors: Laufey
authors: L
authors: Tryggvadóttir
authors: Eiríkur
authors: E
authors: Jónsson
authors: Anna
authors: A
authors: Bill-Axelson
authors: Erik
authors: E
authors: Holmberg
authors: Hans Henrik
authors: HH
authors: Storm
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D006801:Humans; D007055:Iceland / Q000453:epidemiology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000032:analysis; D011471:Prostatic Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology; D012042:Registries / Q000706:statistics & numerical data*; D016019:Survival Analysis; D015996:Survival Rate / Q000639:trends; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors
chemical_list: D017430:Prostate-Specific Antigen