Variation in survival of patients with prostate cancer in Europe since 1978. EUROCARE Working Group.

Since the incidence of prostate cancer has increased considerably over the past two decades in most European countries, knowledge of the variation in survival is pertinent. The collaboration across Europe in the EUROCARE study has now been extended to 45 registries in 17 countries. We report on variation in relative survival according to age of 65,728 patients diagnosed with prostate cancer between 1985 and 1989 and also explore time trends since 1978 for most countries. Considerable variation in survival was found within and between countries, with the highest survival in Switzerland (5-year relative survival 72%), followed by Germany (67%) and the Nordic countries (except Denmark). The lowest survival was found in Estonia (39%), preceded by Slovenia (40%), Denmark (41%) and England (45%). Between 1978 and 1986, relative survival barely changed over time, but it improved from 55% (95% confidence interval [CI] 53-57) during 1984-1986 to 59% (CI 56-61) during 1987-1989. A small but unexpected deterioration of survival for patients aged between 45 and 54 years from 61% to 56% was observed in the early 1980s. It is likely that variation in both detection methods and treatment plays a role in the observed variation in survival, but more information is needed to assess each contribution.