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Prostate cancer incidence and mortality trends in 37 European countries: An overview

04/11/2010
F. Bray, J. Lortet-Tieulent , J. Ferlay , D. Forman, A. Auvinen
Prostate cancer incidence and mortality trends in 37 European countries: An overview
European Journal of Cancer
Volume 46, Issue 17 , Pages 3040-3052, November 2010
doi:10.1016/j.ejca.2010.09.013

Prostate cancer has emerged as the most common cancer in men in Europe, with incidence increasing rapidly in many European countries over the past two decades. A comparison of prostate cancer incidence 2001–2005 in 24 European countries reveals a fivefold variation, with incidence rates relatively low in the Russian Federation compared with the high rates observed in Finland and Sweden.

The highest prostate cancer mortality rates can be found in the Baltic region (Estonia, Latvia and Lithuania) and in Denmark, Norway and Sweden. In contrast to the uniform increases in incidence, prostate cancer mortality has been decreasing in 13 of 37 European countries considered – predominantly in higher-resource countries within each region – such trends were first seen in England and Wales (in 1992) and observed most recently in the Czech Republic (in 2004).

There is considerable variability in the magnitude of the mean annual declines in prostate cancer in Europe, varying from approximately 1% per year in Scotland (from 1994) to over 4% for the more recent declines in Hungary, France and the Czech Republic. There appears to be little correlation between the extent of the increase in incidence (in the late 1990s) and the recent declines in mortality (from 1996). It remains unclear to what extent the increasing trends in incidence rates indicate true risk and how much is due to detection of latent disease.

The decreasing prostate cancer mortality rates after 1990 in selected countries may be attributable to improvements in treatment and to an effect of prostate specific antigen (PSA) testing. The increasing mortality rates in the Baltic region and in several Central and Eastern European countries require further monitoring. The trends may reflect true changes in risk, although the increasing detection of latent disease may also be a contributory factor.

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