Prostate cancer incidence and newly diagnosed patient profile in Spain in 2010

Abstract

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.

Plasma ghrelin O‐acyltransferase (GOAT) enzyme levels: A novel non‐invasive diagnosis tool for patients with significant prostate cancer

“…PSA has been used as the gold standard biomarker for the diagnosis of PCa since the 1990s, although its use remains controversial because of its lack of specificity. Specifically, although the proportion of men with metastatic PCa at the time of diagnosis have decreased dramatically with the introduction of PSA as a screening test, more men are being diagnosed with PCa, with the majority having early stage, clinically indolent disease, the majority of which may never have led to harm . In addition, many men with benign conditions such as inflammation or hyperplasia are also being diagnosed and biopsied based on the results of the PSA test .…”

“…Specifically, although the proportion of men with metastatic PCa at the time of diagnosis have decreased dramatically with the introduction of PSA as a screening test, more men are being diagnosed with PCa, with the majority having early stage, clinically indolent disease, the majority of which may never have led to harm. 12 In addition, many men with benign conditions such as inflammation or hyperplasia are also being diagnosed and biopsied based on the results of the PSA test. 3 Moreover, it has been proposed that treatment of indolent cancer may cause a patient more harm than good as biopsies and PCa treatments have been associated with psychological distress, loss of bodily function, pain, suffering for patients and with a decrease in the patient QoL.…”

Management and Characteristics of Patients with Metastatic Prostate Cancer in a Cohort of New Zealand Men

“…This is a greater proportion than that which has been found to have stage IV disease in a US study using the SEER data (6.4%) [11] or in a similar study from Spain (4%) [12]. Both countries have a high use of PSA testing and therefore an increasing proportion of men with low-risk prostate cancer at diagnosis.…”

A correlation study of BK Polyoma Virus infection and prostate Cancer among Sudanese patients - immunofluorescence and molecular based case-control study

“…It is estimated that there will be almost 1.3 million new cases of prostate cancer and 359,000 associated deaths worldwide in 2018, ranking second among the most frequent cancer cases and the fifth leading cause of cancer deaths among men [4]. Many studies have been conducted in different areas of PCa including causes, risk factors, and diagnosis and treatment options [27].…”