title: Trends in net survival from prostate cancer in six European Latin countries: results from the SUDCAN population-based study.
abstract: Cancer survival is a key measure of the effectiveness of a health-care system. European Latin countries have some differences in their health system; therefore, it is of interest to compare them in terms of survival from cancer. Prostate cancer data from six countries (Belgium, France, Italy, Portugal, Spain, and Switzerland) were extracted from the EUROCARE-5 database (end of follow-up: 1 January 2009). First, the net survival (NS) was studied over the 2000-2004 period using the Pohar-Perme estimator. For trend analyses, the study period was specific to each country. Trends in NS over the 1989-2004 period and changes in the pattern of cancer excess mortality rate until 5 years after the diagnosis were examined using a multivariate excess mortality rate model. A striking increase in survival from prostate cancer occurred in European Latin countries at all ages studied. In the last period of the study, there was little difference in age-standardized NSs from prostate cancer between the six countries. The trends of the survival followed those of the incidence (except in Spain in the elderly); the increases in incidence were the highest at ages 60-70 years and, in the elderly (around 80 years), the incidence did not increase in Switzerland. The increases in NS can mainly be explained by lead-time and overdiagnosis effects. The epidemiological interpretability of the changes in prostate cancer survival in Latin countries is strongly compromised by the biases inherent to the extensive prostate-specific antigen testing.
authors.affiliation: aClaudius Regaud Institute, IUCT-O, Tarn Cancer Registry bLEASP - UMR 1027 Inserm Toulouse III University, Toulouse cDepartment of Biostatistics, University Hospital of Lyon, Lyon dUniversity of Lyon 1 eCNRS, UMR 5558, Biometry and Evolutionary Biology Laboratory (LBBE), BioMaths-Health Department, Villeurbanne, France fCatalan Institute of Oncology, Girona gBasque Health Department, Basque Cancer Registry, Public Health Division of Gipuzkoa, Bilbao hCIBER of Epidemiology and Public Health (CIBERESP), Donostia-San Sebastián, Spain.
authors.forename: Pascale
authors.initials: P
authors.lastname: Grosclaude
authors.forename: Laurent
authors.initials: L
authors.lastname: Roche
authors.forename: Rafael
authors.initials: R
authors.lastname: Fuentes-Raspall
authors.forename: Nerea
authors.initials: N
authors.lastname: Larrañaga
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001530:Belgium / Q000453:epidemiology; D016208:Databases, Factual / Q000639:trends*; D005060:Europe / Q000453:epidemiology; D005602:France / Q000453:epidemiology; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods; D011174:Portugal / Q000453:epidemiology; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis / Q000401:mortality*; D012042:Registries; D013030:Spain / Q000453:epidemiology; D015996:Survival Rate / Q000639:trends; D013557:Switzerland / Q000453:epidemiology; D055815:Young Adult
chemical_list: D017430:Prostate-Specific Antigen