UroToday - Secular Trends in Prostate Cancer Mortality, Incidence and Treatment: England and Wales, 1975-2004 - Abstract

[Guest guest]

http://www.urotoday.com/61/browse_categories/prostate_cancer/secular_trends_in_prostate_cancer_mortality_incidence_and_treatment_england_and_wales_19752004__abstract.html

or

http://tinyurl.com/2mzus7

Friday, 08 February 2008

South-West

Public Health Observatory, Bristol,

UK.

To aid

the interpretation of the trends in prostate

cancer

mortality, which declined in the UK

in the early 1990s for unknown reasons, by investigating prostate

cancer

death rates, incidence and treatments in England

and Wales

in 1975-2004.

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).

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 >/=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).

The

decrease in prostate

cancer

mortality was greater amongst men aged 55-74 years than in those aged >/=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.

Written

by

Hussain S, Gunnell D, Donovan J, McPhail S, Hamdy F, Neal D, Albertsen P, Verne

J, s P, Trotter C, RM.