title: Cancer surveillance using registry data: Results and recommendations for the Lithuanian national prostate cancer early detection programme.
abstract: BACKGROUND
  We describe long term trends in prostate cancer epidemiology in Lithuania, where a national prostate specific antigen (PSA) test based early detection programme has been running since 2006.
  
  
  METHODS
  We used population-based cancer registry data, supplemented by information on PSA testing, life expectancy and mortality from Lithuania to examine age-specific prostate cancer incidence, mortality and survival trends among men aged 40+ between 1978 and 2009, as well as life expectancy of screening-eligible men, and the proportion of men with a first PSA test per year since the programme started.
  
  
  RESULTS
  The number of prostate cancer patients rose from 2.237 in 1990-1994 to 15.294 in 2005-2009. By 2010, around 70% of the eligible population was tested, on average around two times. The early detection programme brought about the highest prostate cancer incidence peaks ever seen in a country to date. Recent incidence and survival rises in the age groups 75-84 suggest PSA testing in the elderly non-eligible population. Life expectancy of men aged 70-74 indicates that less than 30% of patients will live for 15 years and may have a chance to benefit from early detection.
  
  
  CONCLUSIONS
  Early detection among men aged 70-74, and particularly among the elderly (75+) may have to be reconsidered. Life expectancy assessment before testing, avoiding a second test among men with low PSA values and increasing the threshold for further evaluation and the screening interval may help reducing harm. Publishing information on treatment modalities, side-effects and patient reported quality of life is recommended.
authors.affiliation: Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany. Electronic address: a.gondos@dkfz.de.
authors.forename: Adam
authors.initials: A
authors.lastname: Gondos
authors.affiliation: Lithuanian Cancer Registry, National Cancer Institute, Lithuania.
authors.forename: Agne
authors.initials: A
authors.lastname: Krilaviciute
authors.affiliation: Lithuanian Cancer Registry, National Cancer Institute, Lithuania.
authors.forename: Giedre
authors.initials: G
authors.lastname: Smailyte
authors.affiliation: National Cancer Institute, Oncourology Department, Lithuania.
authors.forename: Albertas
authors.initials: A
authors.lastname: Ulys
authors.affiliation: Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany; German Cancer Consortium (DKTK), Heidelberg, Germany.
authors.forename: Hermann
authors.initials: H
authors.lastname: Brenner
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D055088:Early Detection of Cancer / Q000379:methods*; D006801:Humans; D015994:Incidence; D008097:Lithuania / Q000453:epidemiology; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D015397:Program Evaluation; D017430:Prostate-Specific Antigen / Q000032:analysis; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000453:epidemiology*; D012042:Registries
chemical_list: D017430:Prostate-Specific Antigen
keywords: Epidemiology; National early detection programme; PSA-test; Prostate cancer