title: Model-based patterns in prostate cancer mortality worldwide.
abstract: BACKGROUND
  Prostate cancer mortality has been decreasing in several high income countries and previous studies analysed the trends mostly according to geographical criteria. We aimed to identify patterns in the time trends of prostate cancer mortality across countries using a model-based approach.
  
  
  METHODS
  Model-based clustering was used to identify patterns of variation in prostate cancer mortality (1980-2010) across 37 European, five non-European high-income countries and four leading emerging economies. We characterised the patterns observed regarding the geographical distribution and gross national income of the countries, as well as the trends observed in mortality/incidence ratios.
  
  
  RESULTS
  We identified three clusters of countries with similar variation in prostate cancer mortality: pattern 1 ('no mortality decline'), characterised by a continued increase throughout the whole period; patterns 2 ('later mortality decline') and 3 ('earlier mortality decline') depict mortality declines, starting in the late and early 1990s, respectively. These clusters are also homogeneous regarding the variation in the prostate cancer mortality/incidence ratios, while are heterogeneous with reference to the geographical region of the countries and distribution of the gross national income.
  
  
  CONCLUSIONS
  We provide a general model for the description and interpretation of the trends in prostate cancer mortality worldwide, based on three main patterns.
authors: Institute of Public Health of the University of Porto, Porto, Portugal.
authors: F
authors: F
authors: Fontes
authors: M
authors: M
authors: Severo
authors: C
authors: C
authors: Castro
authors: S
authors: S
authors: Lourenço
authors: S
authors: S
authors: Gomes
authors: F
authors: F
authors: Botelho
authors: C
authors: C
authors: La Vecchia
authors: N
authors: N
authors: Lunet
mesh_terms: D000367:Age Factors; D000368:Aged; D016000:Cluster Analysis; D014943:Global Health; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009026:Mortality / Q000639:trends; D011471:Prostatic Neoplasms / Q000401:mortality*
references: Lancet. 2002 Jul 13;360(9327):103-6
references: 12126818
references: Int J Cancer. 2001 Jun 15;92(6):893-8
references: 11351313
references: Int J Cancer. 2008 Jul 15;123(2):421-429
references: 18452171
references: Hum Reprod. 2001 May;16(5):1007-11
references: 11331652
references: Lancet Oncol. 2008 May;9(5):445-52
references: 18424233
references: N Engl J Med. 2012 Jul 19;367(3):203-13
references: 22808955
references: Epidemiol Rev. 2001;23(1):3-13
references: 11588851
references: J Clin Oncol. 2009 Jun 20;27(18):2924-30
references: 19433689
references: J Natl Cancer Inst. 2003 Jun 18;95(12):868-78
references: 12813170
references: J Natl Cancer Inst. 2009 Mar 18;101(6):374-83
references: 19276453
references: Am J Epidemiol. 1999 Oct 15;150(8):848-60
references: 10522656
references: Microsc Res Tech. 2000 Dec 1;51(5):415-8
references: 11074610
references: N Engl J Med. 2012 Mar 15;366(11):981-90
references: 22417251
references: Eur Urol. 2012 Jun;61(6):1079-92
references: 22424666
references: Eur Urol. 2011 Jul;60(1):1-15
references: 21497988
references: Health Technol Assess. 1997;1(2):i, 1-96
references: 9414541
references: J Natl Cancer Inst. 2007 Dec 19;99(24):1881-7
references: 18073376
references: Addiction. 2006 Sep;101 Suppl 1:6-16
references: 16930156
references: J Natl Cancer Inst. 2012 Jan 18;104(2):125-32
references: 22228146
references: Eur J Cancer. 2010 Nov;46(17):3040-52
references: 21047585
references: Lancet. 2011 Dec 17;378(9809):2104-11
references: 22056152
references: N Engl J Med. 2011 May 5;364(18):1708-17
references: 21542742
references: Scand J Clin Lab Invest. 2003;63(5):331-8
references: 14599155
references: Lancet Oncol. 2003 Apr;4(4):233-41
references: 12681267
references: Lancet. 2012 Nov 24;380(9856):1840-50
references: 23079588
references: J Natl Cancer Inst. 1999 Jun 16;91(12):1025-32
references: 10379965