Influence of the diagnostic protocol and age on the prostate cancer incidence rate in Castilla y León according to the national registry 2010.

Abstract

OBJECTIVE\nCross-sectional descriptive observational study of incidence and association, to determine whether the higher incidence of prostate cancer in Castilla y León (with respect to the national rate) could be due to modifiable factors.\n\n\nLOCATION\nUniversity Hospital Río Hortega.\n\n\nPARTICIPANTS\nNew prostate cancer diagnoses.\n\n\nMAIN MEASUREMENTS\nIncidence rate (IR). Age, family history, symptoms, comorbidity, rectal examination, ultrasound volume (cc), PSA (ng/mL), cylinders, volume cylinder ratio, Gleason, TNM and D Amico groups.\n\n\nRESULTS\nCastilla y León showed the highest prostate cancer IR in Spain (141.1 per 100,000 inhabitants per year), with a peak of early incidence (65-74 years) and significant differences in\u202f<\u202f64 and 65-74 years. Age at diagnosis was the lowest (Castilla y León, 66.9\u202f±7.1 vs. Spain, 69.1\u202f±\u202f8.2 years; P\u202f<\u202f.001). No differences: family history, symptoms, comorbidity and PSA. The number of cylinders was 10.7\u202f±\u202f1.8. In multivariate analysis (AUC\u202f=\u202f0.801; P\u202f<\u202f.001), they were more frequent in Castilla y León: grade i rectal examination, non-palpable rectal examination, Gleason\u202f<\u202f6, stage T2c and the volume cylinder ratio\u202f<\u202f6 (only in\u202f<\u202f64 years: OR 5.2; 95% CI 1.2-22-22.3; P\u202f=\u202f.027). In Spanish regions, volume cylinder ratio showed inverse correlation with IR in\u202f<\u202f74 years, while age showed positive correlation in all age groups.\n\n\nCONCLUSIONS\nThe higher prostate cancer IR in Castilla y León in 2010 was not associated to an older population. However, the biopsy technique influenced IR, as more cylinders were obtained in younger subjects, without conditioning overdiagnosis.