Secular trends in prostate cancer mortality, incidence and treatment: England and Wales, 1975-2004.

Abstract:

OBJECTIVE:To aid the interpretation of the trends in prostate cancer mortality, which declined in the UK in the early 1990 s for unknown reasons, by investigating prostate cancer death rates, incidence and treatments in England and Wales in 1975-2004. METHODS:Join-point regression was used to assess secular trends in mortality and incidence (source: Office of National Statistics), radical prostatectomy and orchidectomy (source: Hospital Episode Statistics database) and androgen-suppression drugs (source: Intercontinental Medical Statistics). RESULTS:Prostate cancer mortality declined from 1992 (95% confidence interval, CI, 1990-94). The relative decline in mortality to 2004 was greater and more sustained amongst men aged 55-74 years (annual percentage mortality reduction 2.75%; 95% CI 2.33-3.18%) than amongst those aged >or=75 years (0.71%, 0.26-1.15%). The use of radical prostatectomy increased between 1991 (89 operations) and 2004 (2788) amongst men aged 55-74 years. The prescribing of androgen suppression increased between 1987 (33,000 prescriptions) and 2004 (470,000). CONCLUSIONS:The decrease in prostate cancer mortality was greater amongst men aged 55-74 years than in those aged >or=75 years, but pre-dated the substantial use of prostate-specific antigen screening and radical prostatectomy in the UK. An increase in radical therapy amongst younger groups with localized cancers and screen-detected low-volume locally advanced disease as a result of stage migration, as well as prolonged survival from increased medical androgen suppression therapy, might partly explain recent trends.

journal_name

BJU Int

journal_title

BJU international

authors

Hussain S,Gunnell D,Donovan J,McPhail S,Hamdy F,Neal D,Albertsen P,Verne J,Stephens P,Trotter C,Martin RM

doi

10.1111/j.1464-410X.2007.07338.x

subject

Has Abstract

pub_date

2008-03-01 00:00:00

pages

547-55

issue

5

eissn

1464-4096

issn

1464-410X

pii

BJU7338

journal_volume

101

pub_type

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