Prostate cancer incidence and mortality in the Baltic states, Belarus, the Russian Federation and Ukraine

Abstract

BackgroundProstate cancer incidence varies internationally largely attributable to differences in prostate-specific antigen (PSA) use. The aim of this study was to provide the most recent detailed international epidemiological comparison of prostate cancer incidence and mortality in six north-eastern European countries (Belarus, Estonia, Latvia, Lithuania, the Russian Federation and Ukraine).MethodsThe number of incident prostate cancer cases was obtained from the countries national cancer registries. Prostate cancer mortality and corresponding population data were extracted from the WHO Mortality Database. Age-specific and age-standardised incidence and mortality rates were calculated (European Standard). The joinpoint regression model was used to provide an average annual percentage change and to detect points in time where significant changes in trends occurred. The observation period was between 13 (Ukraine) and 48 (Estonia) years regarding incidence and around 30 years regarding mortality.ResultsThe comparison of prostate cancer incidence in six European countries showed almost sixfold differences in the age-adjusted rates in most recent years with highest incidence rates in Lithuania and Estonia. Through the observation period, overall a continuous rise was seen in incidence in all countries and a continuous rise in mortality, with a stabilisation in Estonia and a decrease in Lithuania in recent years. Data limitations included a descriptive design using ecological data.ConclusionsA widespread use of PSA testing seems to be responsible for the changes in the epidemiology of the disease in north-eastern European countries. Substantial variation in the incidence of prostate cancer in the Baltic states suggests the possibility that PSA performance and utilisation spread have had a major influence on observed incidence trends, with a lack of effect on prostate cancer mortality.

All-Cause Mortality Risk in National Prostate Cancer Cohort: An Impact of Population-Based Prostate Cancer Screening

“…These changes were followed by a mortality decrease by 37% from baseline prostate cancer mortality level [ 6 ]. In Lithuania, there was observed increasing mortality trend from 1985 to 2006 by 3.6% annually and decreasing mortality trend from 2006 by 1.4% annually [ 14 ].…”

“…This program works in the setting of nationwide PSA test-based screening and 70% of men aged 50 years to 74 years have participated in the prostate cancer program at least once in the first 10 years of the screening. During the screening period, prostate cancer incidence exhibited a dramatic increase in incidence and reached 279.33 cases per 100,000 (from 69.32 cases per 100,000 in 2000, European standard), with slowly decreasing prostate cancer mortality since 2007 [ 14 ]. However, all-cause and other cause mortality risk differences after implementation of prostate screening in Lithuania have never been investigated.…”

Changing Incidence and Stage Distribution of Prostate Cancer in a Lithuanian Population—Evidence from National PSA-Based Screening Program

“…There has been a rapid incidence peak since the start of screening program, followed by a decrease thereafter. In Lithuania, PSA became available in 2000, and in 2006, a nationwide PSA-based prostate cancer early detection program was started [7]. Since the start of the program, in the period between 2006–2010 around 72–78% of the total eligible male population received at least one PSA test [5].…”

“…Thereafter, these incidence changes led to a decrease in the incidence rate. Mortality in Lithuania had been continuously growing, however, in 2006 mortality started to decrease by 1.4% annually [7]. This decrease is unlikely attributable to the success of the early effects of EPCDP, as the start of decrease is the same as the start of the program.…”

Impact of diabetes and metformin use on prostate cancer

“…Lithuania is an interesting country to study the interaction between diabetes and PCa. In a recent publication comparing data from Belarus, Estonia, Latvia, Lithuania, the Russian Federation and the Ukraine [7], it was shown that the highest incidence of PCa was found in the Baltic States such as Lithuania and low incidence in Belarus, the Russian Federation and Ukraine. Furthermore, the annual percentage changes (APC) showed the largest increase in Lithuania.…”