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Clinical characteristics and primary treatment of prostate cancer in Sweden between 1996 and 2005 - Data from the national prostate cancer register in Sweden

Adolfsson, Jan ; Garmo, Hans ; Varenhorst, Eberhard ; Ahlgren, Göran LU ; Ahlstrand, Christer ; Andren, Ove ; Bill-Axelson, Anna ; Bratt, Ola LU ; Damber, Jan-Erik and Hellstrom, Karin , et al. (2007) In Scandinavian Journal of Urology and Nephrology 41(6). p.456-477
Abstract
Objective. The incidence of prostate cancer is rising rapidly in Sweden and there is a need to better understand the pattern of diagnosis, tumor characteristics and treatment. Material and methods. Between 1996 and 2005, all new cases of adenocarcinoma of the prostate gland were intended to be registered in the National Prostate Cancer Register (NPCR). This register contains information on diagnosing unit, date of diagnosis, cause of diagnosis, tumor grade, tumor stage according to the TNM classification in force, serum prostate-specific antigen (PSA) levels at diagnosis and primary treatment given within the first 6 months after diagnosis. Results. In total, 72 028 patients were registered, comprising > 97% of all pertinent incident... (More)
Objective. The incidence of prostate cancer is rising rapidly in Sweden and there is a need to better understand the pattern of diagnosis, tumor characteristics and treatment. Material and methods. Between 1996 and 2005, all new cases of adenocarcinoma of the prostate gland were intended to be registered in the National Prostate Cancer Register (NPCR). This register contains information on diagnosing unit, date of diagnosis, cause of diagnosis, tumor grade, tumor stage according to the TNM classification in force, serum prostate-specific antigen (PSA) levels at diagnosis and primary treatment given within the first 6 months after diagnosis. Results. In total, 72 028 patients were registered, comprising > 97% of all pertinent incident cases of prostate cancer in the Swedish Cancer Register (SCR). During the study period there was a considerable decrease in median age at the time of diagnosis, a stage migration towards smaller tumors, a decrease in median serum PSA values at diagnosis, a decrease in the age-standardized incidence rate of men diagnosed with distant metastases or with a PSA level of > 100 ng/ml at diagnosis and an increase in the proportion of tumors with Gleason score <= 6. Relatively large geographical differences in the median age at diagnosis and the age-standardized incidence of cases with category T1c tumors were observed. Treatment with curative intent increased dramatically and treatment patterns varied according to geographical region. In men with localized tumors and a PSA level of <20 ng/ml at diagnosis, expectant treatment was more commonly used in those aged >= 75 years than in those aged <75 years. Also, the pattern of endocrine treatment varied in different parts of Sweden. Conclusions. All changes in the register seen over time are consistent with increased diagnostic activity, especially PSA testing, resulting in an increased number of cases with early disease, predominantly tumors in category T1c. The patterns of diagnosis and treatment of prostate cancer vary considerably in different parts of Sweden. The NPCR continues to be an important source for research, epidemiological surveillance of the incidence, diagnosis and treatment of prostate cancer. (Less)
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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
register, population-based, prostate cancer, epidemiology, time trends
in
Scandinavian Journal of Urology and Nephrology
volume
41
issue
6
pages
456 - 477
publisher
Taylor & Francis
external identifiers
  • wos:000251281000001
  • scopus:36749018047
ISSN
0036-5599
DOI
10.1080/00365590701673625
language
English
LU publication?
yes
additional info
The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Department of Urology, Lund (013077000), Pediatrics/Urology/Gynecology/Endocrinology (013240400)
id
18bdce4b-f68d-4676-bdb7-578448bffdc0 (old id 968744)
date added to LUP
2016-04-01 15:17:58
date last changed
2022-05-08 02:34:18
@article{18bdce4b-f68d-4676-bdb7-578448bffdc0,
  abstract     = {{Objective. The incidence of prostate cancer is rising rapidly in Sweden and there is a need to better understand the pattern of diagnosis, tumor characteristics and treatment. Material and methods. Between 1996 and 2005, all new cases of adenocarcinoma of the prostate gland were intended to be registered in the National Prostate Cancer Register (NPCR). This register contains information on diagnosing unit, date of diagnosis, cause of diagnosis, tumor grade, tumor stage according to the TNM classification in force, serum prostate-specific antigen (PSA) levels at diagnosis and primary treatment given within the first 6 months after diagnosis. Results. In total, 72 028 patients were registered, comprising &gt; 97% of all pertinent incident cases of prostate cancer in the Swedish Cancer Register (SCR). During the study period there was a considerable decrease in median age at the time of diagnosis, a stage migration towards smaller tumors, a decrease in median serum PSA values at diagnosis, a decrease in the age-standardized incidence rate of men diagnosed with distant metastases or with a PSA level of &gt; 100 ng/ml at diagnosis and an increase in the proportion of tumors with Gleason score &lt;= 6. Relatively large geographical differences in the median age at diagnosis and the age-standardized incidence of cases with category T1c tumors were observed. Treatment with curative intent increased dramatically and treatment patterns varied according to geographical region. In men with localized tumors and a PSA level of &lt;20 ng/ml at diagnosis, expectant treatment was more commonly used in those aged &gt;= 75 years than in those aged &lt;75 years. Also, the pattern of endocrine treatment varied in different parts of Sweden. Conclusions. All changes in the register seen over time are consistent with increased diagnostic activity, especially PSA testing, resulting in an increased number of cases with early disease, predominantly tumors in category T1c. The patterns of diagnosis and treatment of prostate cancer vary considerably in different parts of Sweden. The NPCR continues to be an important source for research, epidemiological surveillance of the incidence, diagnosis and treatment of prostate cancer.}},
  author       = {{Adolfsson, Jan and Garmo, Hans and Varenhorst, Eberhard and Ahlgren, Göran and Ahlstrand, Christer and Andren, Ove and Bill-Axelson, Anna and Bratt, Ola and Damber, Jan-Erik and Hellstrom, Karin and Hellstrom, Magnus and Holmberg, Erik and Holmberg, Lars and Hugosson, Jonas and Johansson, Jan-Erik and Petterson, Bill and Tornblom, Magnus and Widmark, Anders and Stattin, Par}},
  issn         = {{0036-5599}},
  keywords     = {{register; population-based; prostate cancer; epidemiology; time trends}},
  language     = {{eng}},
  number       = {{6}},
  pages        = {{456--477}},
  publisher    = {{Taylor & Francis}},
  series       = {{Scandinavian Journal of Urology and Nephrology}},
  title        = {{Clinical characteristics and primary treatment of prostate cancer in Sweden between 1996 and 2005 - Data from the national prostate cancer register in Sweden}},
  url          = {{http://dx.doi.org/10.1080/00365590701673625}},
  doi          = {{10.1080/00365590701673625}},
  volume       = {{41}},
  year         = {{2007}},
}