Cohort Profile Update: The National Prostate Cancer Register of Sweden and Prostate Cancer data Base—a refined prostate cancer trajectory

Hemelrijck, Mieke Van; Garmo, Hans; Wigertz, Annette; Nilsson, Per; Stattin, Pär

doi:10.1093/ije/dyv305

Cited by 87 publications

(118 citation statements)

References 6 publications

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“…PCBaSe Sweden 3.0 is based on the National Prostate Cancer Register of Sweden (NPCR), which became nationwide in 1998 and covers 98% of all newly diagnosed cases of PCa, as compared with the Swedish Cancer Register . The NPCR includes information on date of diagnosis, age at diagnosis, tumour stage and differentiation, and serum levels of PSA at time of diagnosis.…”

Section: Study Population and Methodsmentioning

confidence: 99%

“…PCBaSe traject includes all of the data in PCBaSe 3.0, but has additional linkages. It focuses specifically on men diagnosed with PCa between 1992 and 2012 with available information on their complete treatment trajectory . For the present study, we included all men diagnosed with intermediate‐ or high‐risk localized PCa (i.e.…”

Section: Study Population and Methodsmentioning

confidence: 99%

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Association between type 2 diabetes, curative treatment and survival in men with intermediate‐ and high‐risk localized prostate cancer

et al. 2017

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ObjectiveTo investigate whether curative prostate cancer (PCa) treatment was received less often by men with both PCa and Type 2 diabetes mellitus (T2DM) as little is known about the influence of T2DM diagnosis on the receipt of such treatment in men with localized PCa. Subjects and MethodsThe Prostate Cancer database Sweden (PCBaSe) was used to obtain data on men with T2DM and PCa (n = 2210) for comparison with data on men with PCa only (n = 23 071). All men had intermediate-(T1-2, Gleason score 7 and/or prostate-specific antigen [PSA] 10-20 ng/mL) or high-risk (T3 and/or Gleason score 8-10 and/or PSA 20-50 ng/mL) localized PCa diagnosed between 1 January 2006 and 31 December 2014. Multivariate logistic regression was used to calculate the odds ratios (ORs) for receipt of curative treatment in men with and without T2DM. Overall survival, for up to 8 years of follow-up, was calculated both for men with T2DM only and for men with T2DM and PCa. ResultsMen with T2DM were less likely to receive curative treatment for PCa than men without T2DM (OR 0.78, 95% confidence interval 0.69-0.87). The 8-year overall survival rates were 79% and 33% for men with T2DM and high-risk PCa who did and did not receive curative treatment, respectively. ConclusionsMen with T2DM were less likely to receive curative treatment for localized intermediate-and high-risk PCa. Men with T2DM and high-risk PCa who received curative treatment had substantially higher survival times than those who did not. Some of the survival differences represent a selection bias, whereby the healthiest patients received curative treatment. Clinicians should interpret this data carefully and ensure that individual patients with T2DM and PCa are not under-nor overtreated.

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Section: Study Population and Methodsmentioning

confidence: 99%

Section: Study Population and Methodsmentioning

confidence: 99%

Association between type 2 diabetes, curative treatment and survival in men with intermediate‐ and high‐risk localized prostate cancer

et al. 2017

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Section: Methodsmentioning

confidence: 99%

“…Follow up started on 1st January 2006 and ended at date of death, date of emigration, date of T2DM prescription, or 31 December 2013, whichever came first. Men who received AA or GnRH according to NPCR and had a date of diagnosis prior to 1st January 2006 and were found to still be receiving them according to the Prescribed Drug Register during the “run in period” were considered to have been “exposed” since the date of diagnosis . All other exposure to AA or GNRH was defined as time from first filled prescription.…”

Section: Methodsmentioning

confidence: 99%

“…PCBaSe Sweden 3.0 is based on the National Prostate Cancer Register (NPCR) of Sweden, which became nationwide in 1998 and covers 98% of all newly diagnosed cases of PCa, as compared to the Swedish Cancer Register. 14,15 NPCR includes information on date of diagnosis, age at diagnosis, tumour stage and differentiation, serum levels of prostate specific antigen (PSA) at time of diagnosis, and primary treatment within 6 months after date of diagnosis. Risk categories were determined according to a modified version of the National Comprehensive Cancer Network Guideline 16 as follows: Low risk: T1-2, Gleason score of 2-6 and PSA< 10 ng/ml; intermediate risk: T1-2, Gleason score 7 and/or PSA 10-20 ng/ml; high risk: T3and/or Gleason score 8-10 and/or PSA 20-50 ng/ml; regionally metastatic/locally advanced:T4 and/or N1 and/or PSA 50-100 ng/ml in the absence of distant metastases (M0 or MX); distant metastases: M1 and/or PSA > 100 ng/ml.…”

Section: Study Population and Data Collectionmentioning

confidence: 99%

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Association between duration and type of androgen deprivation therapy and risk of diabetes in men with prostate cancer

Crawley

Garmo

Stattin

et al. 2016

Intl Journal of Cancer

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Androgen deprivation therapy (ADT) for prostate cancer (PCa) increases risk of type 2 diabetes (T2DM); however the association between types and duration of ADT has not been fully elucidated. We examined how type and duration of ADT affects risk of T2DM. Using data from Prostate Cancer database Sweden (PCBaSe) we investigated risk of T2DM in a cohort of 34,031 men with PCa on ADT; i.e., anti‐androgens (AA), orchiectomy, or gonadotropin‐releasing hormone (GnRH) agonists compared to an age‐matched, PCa‐free comparison cohort (n = 167,205) using multivariate Cox proportional hazard regression. T2DM was defined as a newly filled prescription for metformin, sulphonylurea, or insulin in the Prescribed Drug Register. A total of 21,874 men with PCa received GnRH agonists, 9,143 AA and 3,014 underwent orchiectomy. Risk of T2DM was increased in men in the GnRH agonists/orchiectomy group during the first 3 years of ADT [i.e., 1 − 1.5 years HR: 1.61 (95%CI: 1.36 − 1.91)], compared to PCa‐free men. The risk decreased thereafter (e.g., 3 − 4 years HR: 1.17 (95% CI: 0.98 − 1.40)). Conversely, no increased risk was seen in men on AA (HR: 0.74 (95%CI: 0.65 − 0.84). The incidence of T2DM per 1,000 person‐years was 10 for PCa‐free men, 8 for men on AA, and 13 for men on GnRH agonists/orchiectomy. Duration of ADT has a significant impact on risk of T2DM. With the peak after three years of treatment, our data indicates that men on ADT, even for a limited period of time, such as adjuvant to radiotherapy, are at increased risk of T2DM.

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Variation in Prostate-Specific Antigen Testing Rates and Prostate Cancer Treatments and Outcomes in a National 20-Year Cohort

et al. 2021

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IMPORTANCEThe diagnostic activity for prostate cancer has increased during the past decades.However, the benefit and harm of the increased diagnostic activity have not been quantified in detail for a country or a large region.OBJECTIVE The aim of this study was to evaluate and quantify the association between increases in diagnostic activity driven by prostate-specific antigen testing and incidence of prostate cancer diagnosis, treatment, and mortality. DESIGN, SETTING, AND PARTICIPANTSThis cohort study used the Proxy-Based Risk-Stratified Incidence Simulation Model-Prostate Cancer to examine observed data on all Swedish men with prevalent prostate cancer and compare them with a corresponding, hypothetical, simulated scenario with more restrictive diagnostic activity. All men aged 40 to 100 years living in Sweden during the time period 1996 to 2016 with incident and prevalent prostate cancer were included. The second scenario is the corresponding, hypothetical, simulated scenario where diagnostic activity remained constant as of 1996 (the beginning of the prostate-specific antigen testing era) throughout the study period. EXPOSURES High or low diagnostic activity for prostate cancer. MAIN OUTCOMES AND MEASURES Incidence of prostate cancer diagnosis, treatment (deferred treatment, curative treatment, and hormonal treatment), and prostate cancer mortality.RESULTS During the study period from 1996 to 2016, 188 884 men were diagnosed with prostate cancer at a median (interquartile range) age of 71 (64-77) years. Compared with the low-diagnostic activity scenario, in the high-diagnostic activity scenario, the number of men diagnosed with prostate cancer was 48% higher (423 vs 286 [95% CI, per 100 000 men per year), 148% more men were diagnosed with low-or intermediate-risk cancer (221 vs 89 [95% CI, 73-105] per 100 000 men per year), and 108% more men received curative treatment per 100 000 men per year). There were up to 15% fewer prostate cancer deaths in the scenario with high-diagnostic activity (incidence rate ratio, 0.85; 95% CI, 0.82-0.88).CONCLUSIONS AND RELEVANCE This study's results suggest that increased prostate-specific antigen testing and diagnostic activity are associated with a larger number of men being diagnosed with prostate cancer, predominately with low-and intermediate-risk disease. The increased diagnostic activity was associated with a 2-fold increase in curative treatment and a modest decrease in mortality.

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Cohort Profile Update: The National Prostate Cancer Register of Sweden and Prostate Cancer data Base—a refined prostate cancer trajectory

Cited by 87 publications

References 6 publications

Association between type 2 diabetes, curative treatment and survival in men with intermediate‐ and high‐risk localized prostate cancer

Association between type 2 diabetes, curative treatment and survival in men with intermediate‐ and high‐risk localized prostate cancer

Association between duration and type of androgen deprivation therapy and risk of diabetes in men with prostate cancer

Variation in Prostate-Specific Antigen Testing Rates and Prostate Cancer Treatments and Outcomes in a National 20-Year Cohort

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