Helen S Evans1, Henrik Møller. 1. Thames Cancer Registry, Division of Medicine, Guy's, King's and St. Thomas' School of Medicine, 1st Floor, Capital House, 42 Weston Street, London SE1 3QD, UK. helen.evans@kcl.ac.uk
Abstract
OBJECTIVE: To investigate recent trends in prostate cancer incidence and mortality, with particular reference to changes in diagnostic techniques and treatment. METHODS: The Thames Cancer Registry was used to identify all men, resident in SE England, diagnosed with prostate cancer between 1990 and 1999. Information regarding prostate cancer mortality was obtained from the Office of National Statistics. Other data sources were used to ascertain the number of transurethral resections of the prostate (TURP) and open prostatectomies performed in SE England, and the number of prescriptions issued for the treatment of benign prostatic hyperplasia (BPH). RESULTS: There was a steady increase in the age-standardised incidence of prostate cancer from 1990, which then began to plateau in 1996. The increase was entirely restricted to localised tumours; non-localised tumours showed a slight downward trend over this period. Age-standardised mortality rates have remained constant, with a slight fall in 1997 corresponding to the decline in incidence rates. Medical treatment for BPH has increased, with a corresponding reduction in the number of TURPs. CONCLUSION: The change in occurrence of prostate cancer is entirely due to changes in the incidence of localised cases. Incidence of non-localised cases and mortality remained almost constant. The increasing tendency in incidence of localised prostate cancer is likely to be principally due to increased detection, through increased use of prostate-specific antigen (PSA) testing followed by radical resections of the prostate. The aggregate effect of PSA testing and medical treatment of BPH is a stabilisation in the incidence level of localised cases in recent years.
OBJECTIVE: To investigate recent trends in prostate cancer incidence and mortality, with particular reference to changes in diagnostic techniques and treatment. METHODS: The Thames Cancer Registry was used to identify all men, resident in SE England, diagnosed with prostate cancer between 1990 and 1999. Information regarding prostate cancer mortality was obtained from the Office of National Statistics. Other data sources were used to ascertain the number of transurethral resections of the prostate (TURP) and open prostatectomies performed in SE England, and the number of prescriptions issued for the treatment of benign prostatic hyperplasia (BPH). RESULTS: There was a steady increase in the age-standardised incidence of prostate cancer from 1990, which then began to plateau in 1996. The increase was entirely restricted to localised tumours; non-localised tumours showed a slight downward trend over this period. Age-standardised mortality rates have remained constant, with a slight fall in 1997 corresponding to the decline in incidence rates. Medical treatment for BPH has increased, with a corresponding reduction in the number of TURPs. CONCLUSION: The change in occurrence of prostate cancer is entirely due to changes in the incidence of localised cases. Incidence of non-localised cases and mortality remained almost constant. The increasing tendency in incidence of localised prostate cancer is likely to be principally due to increased detection, through increased use of prostate-specific antigen (PSA) testing followed by radical resections of the prostate. The aggregate effect of PSA testing and medical treatment of BPH is a stabilisation in the incidence level of localised cases in recent years.
Authors: Jack Cuzick; Gregory P Swanson; Gabrielle Fisher; Arthur R Brothman; Daniel M Berney; Julia E Reid; David Mesher; V O Speights; Elzbieta Stankiewicz; Christopher S Foster; Henrik Møller; Peter Scardino; Jorja D Warren; Jimmy Park; Adib Younus; Darl D Flake; Susanne Wagner; Alexander Gutin; Jerry S Lanchbury; Steven Stone Journal: Lancet Oncol Date: 2011-03 Impact factor: 41.316
Authors: S Hori; T Jabbar; N Kachroo; J C Vasconcelos; C N Robson; V J Gnanapragasam Journal: J Cancer Res Clin Oncol Date: 2011-02 Impact factor: 4.553
Authors: Simon M Collin; Richard M Martin; Chris Metcalfe; David Gunnell; Peter C Albertsen; David Neal; Freddie Hamdy; Peter Stephens; J Athene Lane; Rollo Moore; Jenny Donovan Journal: Lancet Oncol Date: 2008-04-16 Impact factor: 41.316
Authors: Sabina Hussain; David Gunnell; Jenny Donovan; Sean McPhail; Freddie Hamdy; David Neal; Peter Albertsen; Julia Verne; Peter Stephens; Caroline Trotter; Richard M Martin Journal: BJU Int Date: 2008-01-10 Impact factor: 5.588