In order to investigate potential selection bias in population-based cohort studies, participants (n = 28098) and non-participants (n = 40807) in the Malmö Diet and Cancer Study (MDCS) were compared with regard to cancer incidence and mortality. MDCS participants were also compared with participants in a mailed health survey with regard to subjective health, socio-demographic characteristics and lifestyle. Cancer incidence prior to recruitment was lower in non-participants, Cox proportional hazards analysis yielded a relative risk (RR) with a 95% confidence interval of 0.95 (0.90-1.00), compared with participants. During recruitment, cancer incidence was higher in non-participants, RR: 1.08 (1.01-1.17). Mortality was higher in non-participants both during, 3.55 (3.13-4.03), and following the recruitment period, 2.21 (2.03-2.41). The proportion reporting good health was higher in the MDCS than in the mailed health survey (where 74.6% participated), but the socio-demographic structure was similar. We conclude that mortality is higher in non-participants than in participants during recruitment and follow-up. It is also suggested that non-participants may have a lower cancer incidence prior to recruitment but a higher incidence during the recruitment period.

Trial Registration: trial registry, ClinicalTrials.gov; registration number, NCT00412971; http://www.clinicaltrials.gov/ct2/show/ NCT00412971?spons=%22PhotoCure%22&spons_ex=Y&rank=15• Patients were randomized to cystoscopy and WL TURB (118 patients) or WL TURB followed immediately by HAL TURB (115 patients). Cystoscopy/TURB and bladder biopsies were performed under general anaesthesia. No patients had intravesical chemotherapy immediately after TURB.• Recurrences were verified histologically. RESULTS• The two groups were similar regarding age and previous bladder cancer history.• In all, 90 patients from the HAL TURB group had bladder tumour. Fluorescenceguided cystoscopy after complete WL TURB identified residual tumour tissue in 44 of 90 patients (49%). In 37 of 83 (45%) residual Ta tumour was found; in three of seven residual T1 was found and in four cases carcinoma in situ .• True (and false) positive detection rate of photodynamic diagnosis was 64% (25%) and of white light 83% (16%).• In all, 145 patients were eligible for analysis of tumour recurrence. Twelve patients had their last follow-up after 4 months. The recurrence rate in patients followed for 12 months was 47.3% (35/74) after WL TURB and 30.5% (18/59) after HAL TURB ( P = 0.05).• Kaplan-Meier analyses comprising data from all 145 patients showed that the recurrence-free period was significantly longer in the HAL TURB group than in the WL TURB group ( P = 0.02). CONCLUSION• WL TURB often leaves residual tumour in the bladder. HAL TURB improves the detection of Ta/T1 tumours of the bladder resulting in more complete TURB procedures and thus a reduced recurrence rate. KEYWORDSHexvix®, bladder cancer, fluorescence cystoscopy, recurrence, non-muscleinvasive, residual tumour What's known on the subject? and What does the study add? Photodynamic diagnosis (PDD) improves the diagnostic sensitivity of non-invasive bladder cancer as compared to TURB without PDD.TURB in white light leaves residual tumour in the bladder in up to 49% of the patients. PDD-guided TURB improves the detection of Ta/T1 tumours of the bladder resulting in more complete TURB procedures and thus a reduced tumour recurrence rate. Study Type -Therapy (RCT) Level of Evidence 1b OBJECTIVES• To compare the bladder tumour recurrence rate in stage Ta and T1 tumours after conventional transurethral resection of the bladder in white light (WL TURB) and after fluorescence-guided TURB (HAL TURB) using hexaminolaevulinate (HAL: Hexvix®, Photocure, Norway) for photodynamic diagnosis during 12 months of follow-up.• As secondary objectives, to relate the tumour recurrence rate to fluorescencedetected residual tumour after WL TURB and to assess the false positive rate. PATIENTS AND METHODS• This was a prospective, comparative, randomized, open-label study carried out in hospital outpatient urology clinics and the operating theatre. A total of 233 patients presenting with suspected superficial bladder tumour were recruited. Both patients with new tumours and patients with recurrent tumours were inclu...

We present the first survival analysis of a complete, nationwide cohort of men undergoing RP for localised prostate cancer. The main limitation of the study was the relatively short follow-up. Interestingly, our national results are comparable to high-volume, single institution, single surgeon series.

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149 Background: Denmark introduced radical prostatectomy (RP) as the last Nordic country in 1995. Since then, a rapid increment in the Danish incidence of prostate cancer (PCa) is indicative of increasing opportunistic prostate-specific antigen (PSA) testing. We hypothesized that an increasing proportion of men undergo RP for lower-risk PCa. Methods: All patients undergoing RP in Denmark between 1995 and 2011 were included. Changes over time in age at surgery, preoperative PSA, clinical T-category, biopsy Gleason score (GS) are described. Tests for statistically significant changes in trends were performed using linear regression and Cochran-Armitage trend test. Results: Median age at surgery increased from 61.4 to 64.8 (p<0.0001) during the 16 year period. Median preoperative PSA declined from 11.5 to 7.9 ng/ml (p<0.0001). Distribution of biopsy GS changed significantly, especially after 2005. Biopsy GS=7 was found in 20.2% of the patients in 2005 compared to 57.1% in 2011. The proportion of T1 disease increased from 32% to 56%. The proportion of patients above age 65 increased from 26.8% to 48.3% in the 16 year period studied. To adjust for grade, PSA, and age migration, we analyzed changes in the proportion of men age over age 65, with PSA less than or equal to 10 ng/ml, biopsy GS≤3+4, and clinical T1 disease over time. In the 16 year period, this proportion increased from 2% to 16% (p<0-001) of the cohort undergoing RP in Denmark. Conclusions: Significant preoperative age, stage, and Gleason grade migration was found in this complete Danish nation-wide cohort of patients undergoing RP during the past 16 years. This has occurred in the absence of any major changes to the national Danish guidelines for diagnosis and treatment of localized PCa. This effect is likely attributed to an increasing use of PSA although national guidelines recommend against PSA screening. Further, new guidelines from the International Society of Urological Pathology have had a major impact on risk classification. According to recently published randomized trials, the risk of overtreatment of localized PCa with RP is an increasing problem in Denmark.