Homogeneous prostate cancer mortality in the Nordic countries over four decades.
Homogeneous prostate cancer mortality in the Nordic countries over four decades.
复制标题
四十年来北欧国家前列腺癌死亡率均一。
DOI：
10.1016/j.eururo.2010.05.040
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发表时间：
2010
期刊：
影响因子：
23.4
通讯作者：
Adami,Hans-Olov
中科院分区：
文献类型：
--
作者：
Meyer,MaraS;Mucci,LoreleiA;Andersson,Swen-Olof;Andrén,Ove;Johansson,Jan-Erik;Tretli,Steinar;Adami,Hans-Olov
背景技术背景：随着前列腺特异性抗原（PSA）筛查的出现，在过去的二十年中，北欧地区前列腺癌（PCa）的发病率大大增加。因此，解释PCa的时间趋势变得困难，并且暴露于因果因素的变化的影响是不确定的。目的：揭示北欧国家前列腺癌的地理差异和时间趋势。由于前列腺癌的发病率受PSA筛查的影响很大，我们主要分析前列腺癌的死亡率。设计、地点和参与者：我们使用PC-NORDCAN软件程序和NORDCAN在线数据库分析了1965 - 2006年来自丹麦、芬兰、挪威和瑞典的全国PCa发病率和死亡率数据。测量值：计算了四十年中选定日历年的PCa累积发病率和累积死亡率，沿着年龄标准化死亡率。NORDCAN的发病率数据来自各国的癌症登记处，死亡率数据来自国家死亡率登记处。结果和局限性：从1965年到2006年，在四个北欧国家报告了172613例PCa死亡。自1980年代后期以来，整个区域的发病率大幅度上升，但存在一些地理差异。相比之下，疾病特异性死亡率和PCa死亡率的累积风险在同一时期缺乏一致的时间趋势。该地区40年来PCa死亡率的累积风险在3.5%至7.5%之间，而累积发病率从约9%跃升至> 20%。各国的死亡率保持相当稳定，芬兰的风险最低。结论：与大多数恶性肿瘤不同的是，致死性前列腺癌的发生显示出最小的地理变异，并且在40年内缺乏一致的时间趋势。这些发现可能指导我们寻找前列腺癌的重要病因，前列腺癌是一种病因学尚不清楚的恶性肿瘤。
BACKGROUND: Incidence of prostate cancer (PCa) has greatly increased in the Nordic region over the past two decades, following the advent of prostate-specific antigen (PSA) screening. Consequently, interpreting temporal trends in PCa has become difficult, and the impact of changes in exposure to causal factors is uncertain. OBJECTIVE: To reveal geographic differences and temporal trends in PCa in the Nordic countries. Because the recorded incidence of PCa has been profoundly influenced by PSA screening, we focused our analyses primarily on PCa mortality. DESIGN, SETTING, AND PARTICIPANTS: We analyzed national PCa incidence and mortality data from Denmark, Finland, Norway, and Sweden from 1965 to 2006 using the PC-NORDCAN software program and the online NORDCAN database. MEASUREMENTS: Cumulative incidence and cumulative mortality from PCa were calculated for selected calendar years during four decades, along with age-standardized mortality rates. Incidence data in NORDCAN come from individual countries’ cancer registries, and mortality data come from national mortality registries. RESULTS AND LIMITATIONS: From 1965 to 2006, 172 613 deaths from PCa were reported in the four Nordic countries. A substantial rise in incidence was observed across the region, with some geographic variation, since the late 1980s. In contrast, both disease-specific mortality rates and cumulative risk of PCa mortality lacked consistent temporal trends over the same period. Cumulative risk of PCa mortality ranged between 3.5% and 7.5% in the region over four decades, whereas cumulative incidence jumped from about 9% to >20%. Mortality has remained fairly constant among the countries, with a minimally lower risk in Finland. CONCLUSIONS: Unlike most malignancies, the occurrence of lethal PCa showed minimal geographic variation and lacked consistent temporal trends over four decades. These findings may guide our search for important causes of PCa, a malignancy with etiology that is still largely unknown.