To estimate changes in the stage distribution of prostate cancer during the time period where opportunistic PSA-testing was introduced.
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Cancer stage, age and year of diagnosis were obtained for all men over the age of 50 diagnosed with prostate cancer in Norway during the period 1980-2010.
Three calendar-time periods (1980-1989, 1990-2000, and 2001-2010) and three age groups (50-65, 66-74, and 75+) were defined. Birth cohorts were categorized into four intervals: <1915, 1916-1925, 1926-1940 and >1941. We used Poisson regressions to conduct both a time period and cohort-based analysis of trends in the incidence of localised, regional and distant cancer for each combination of age groups and calendar-time periods or birth cohorts, respectively. Additionally, we explored the effect of cohorts on the stage-specific incidence graphically with a Poisson regression using 5-year age groups, and by estimating cumulative incidence rates for each birth cohort.
The annual incidence of localised cancers among men aged 50-65 and 66-74 rose from 41. 4 and 255. 2 per 100,000, respectively, before the introduction of PSA-testing to 137. 9 and 418. 7 in 2001-2010 afterwards, corresponding to 3. 3 (CI: 3. 1; 3. 5) and 1. 6 (CI: 1. 6; 1. 7) fold increases. The incidence of regional cancers increased by a factor seven among men aged
Opportunistic PSA-testing substantially increased the incidence of localised and regional prostate cancers among men aged 50-74 years, which was not fully compensated by the 30% decrease in incidence of distant prostate cancers in older men. This article is protected by copyright. All rights reserved.
BJU international. 2015 Oct 24 [Epub ahead of print]
Mette H Møller, Ivar S Kristiansen, Christian Beisland, Jarle Rørvik, Henrik Støvring
Department of Public Health, Aarhus University, Bartholins Allé 2, 8000, Aarhus, Denmark. , Department of Health Management and Health Economics, Oslo University, Forskningsveien 3a, 0373, Oslo, Norway. , Department of Urology, Surgical Clinic, Haukeland University Hospital, Haukelandsveien 22, 5021, Bergen, Norway. , Department of Clinical Medicine, University of Bergen, Haukelandsveien 22, 5021, Bergen, Norway. , Department of Public Health, Aarhus University, Bartholins Allé 2, 8000, Aarhus, Denmark.