Adam Gondos1, Agne Krilaviciute2, Giedre Smailyte2, Albertas Ulys3, Hermann Brenner4. 1. Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany. Electronic address: a.gondos@dkfz.de. 2. Lithuanian Cancer Registry, National Cancer Institute, Lithuania. 3. National Cancer Institute, Oncourology Department, Lithuania. 4. Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany; German Cancer Consortium (DKTK), Heidelberg, Germany.
Abstract
INTRODUCTION: 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.
INTRODUCTION: 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 cancerpatients 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: Nahara Anani Martínez-González; Stefan Neuner-Jehle; Andreas Plate; Thomas Rosemann; Oliver Senn Journal: BMC Cancer Date: 2018-10-22 Impact factor: 4.430
Authors: Donata Linkeviciute-Ulinskiene; Ausvydas Patasius; Lina Zabuliene; Rimantas Stukas; Giedre Smailyte Journal: Int J Environ Res Public Health Date: 2019-12-30 Impact factor: 3.390