The effects of acne vulgaris on quality of life and changes in quality of life after treatment are not only explainable by objective severity of acne. Patients' and clinicians' judgements about acne severity are different.

Background: Adherence to treatment is a mayor issue in dermatology, and its relationship to quality of life has barely been studied. Objective: To evaluate the relationship between scores on the Skindex-29 skin disease assessment scale and adherence to treatment in patients with acne. Methods: An observational, prospective study of 1,628 patients carried out by 252 clinicians in Spain. Results: Adherence was related to better objective and subjective severity index scores and better Skindex-29 scale scores at the end of the study. Young, male and unemployed patients had the worst adherence scores. Baseline and final Skindex-29 scale scores were significantly worse in non-adherent females, while non-adherent males scored better. Reasons for non-adherence were side effects for older patients and forgetfulness for younger ones. Conclusion: Dermatologists should explain that adherence to treatment is linked to better outcomes and better quality of life. Young females with high Skindex-29 scale scores and males with low Skindex scores are especially prone to non-adherence.

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Study Type – Therapy (practice pattern evaluation) Level of Evidence 2b What's known on the subject? and What does the study add? Prostate cancer (PCa) accounts for 12% of newly diagnosed cases of cancer in Europe. It is one of the most frequently diagnosed tumours in the developed world. Since the introduction of prostate specific antigen as a test for early detection of PCa, the rate of diagnosis has increased significantly and specific mortality has reduced in most western countries. Most of the data on the incidence of PCa are obtained from population‐based cancer registries which frequently do not cover the whole population. This first national hospital‐based PCa registry aims not only to estimate the incidence of the disease but to ascertain the clinical profile of newly diagnosed PCa patients, a useful tool for evaluating the impact of the disease and its socio‐health management. OBJECTIVES To estimate the 2010 incidence of prostate cancer (PCa) in Spain. To describe the clinical profile of newly diagnosed cases using a nationwide hospital‐based registry. PATIENTS AND METHODS This was a national epidemiological observational study in 25 public hospitals with a specific reference population according to the National Health System. Sociodemographic and clinical variables of all newly diagnosed, histopathologically confirmed PCa cases were collected in 2010, in the area of influence of each centre. Cases diagnosed in private practice were not collected (estimated nearly 10% in Spain). Data monitoring was external to guarantee quality and homogeneity. The age‐standardized PCa incidence was determined based on the age distribution of the European standard population. RESULTS In all, 4087 new cases of PCa were diagnosed for a reference population of 4 933 940 men (21.8% of the Spanish male population). The estimated age‐standardized PCa incidence was 70.75 cases per 100 000 men. Mean age at diagnosis was 69 years; 11.6% of patients presented with tumour‐related symptoms and 39.5% with LUTS. Median PSA was 8 ng/mL. Gleason score was ≤6 in 56.5%, 7 in 26.7% and >7 in 16.8% of patients. At diagnosis, 89.8% had localized, 6.4% locally advanced and 3.8% metastatic disease. CONCLUSIONS This study on PCa incidence in Spain, a western country with intensive opportunistic PSA screening, shows that PCa is a high incidence tumour, diagnosed close to 70 years, usually asymptomatic. Almost 40% of cases have low risk disease with a risk of over‐diagnosis and over‐treatment. Around 55% of patients with intermediate or high risk disease are candidates for active therapy which may result in a reduction of cancer‐specific mortality.

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