P. Babb

Patterns and trends in prostate cancer incidence, survival, prevalence and mortality. Part I: international comparisons

The international patterns and trends in prostate cancer incidence, survival, prevalence and mortality were examined. Age‐standardized incidence and death rates among men in a variety of countries worldwide were obtained from various sources, survival rates from European sources and elsewhere, and prevalence estimates from the EUROPREVAL study. Results from many published studies were summarized. The incidence of prostate cancer varies widely around the world, with by far the highest rates in the USA and Canada. There has been a gradual increase in the incidence of prostate cancer since the 1960s in many countries and in most continents; there were large increases in the late 1980s and early 1990s in the USA, but increases have also occurred in countries with comparatively low incidence, e.g. India. Survival from prostate cancer improved during the 1970s and 1980s; further increases in the 1990s may be largely a result of earlier diagnosis. There were wide differences in survival across Europe, with rates in the UK well below the average, but all European rates were far below those in the USA. There was wide variation in the prevalence of prostate cancer in Europe; in some countries with high incidence and high life‐expectancy, prostate cancers formed ≈ 15% of all prevalent cancers in men. Mortality from prostate cancer has also increased in many countries, but to a lesser extent than incidence; this is consistent with the observed trends in survival. Mortality decreased slightly in the mid to late 1990s in several countries, including the USA, Canada, England, France and Austria. Part of the apparent increases in the incidence of prostate cancer has been associated with diagnostic artefacts (particularly detecting preclinical tumours through the increased use of transurethral resection) which may also have had an effect on death certification through the incorrect attribution of prostate cancer as the underlying cause of death. However, the greatest effect on the registration of new cases of prostate cancer has been the increased availability of prostate specific antigen testing during the early‐ to mid‐1990s. Possibly, in addition to the effect of attribution bias, the earlier diagnosis of prostate cancers has contributed to the recent slight decreases in mortality. However, this is unlikely to account for much of the reduction, given the slow development of the disease from onset to death. Changes in disease management are probably more important. There are many strong arguments against introducing population‐based screening for prostate cancer.

Patterns and trends in prostate cancer incidence, survival, prevalence and mortality. Part II: individual countries

Part I of this paper (p. 162 in this issue) contains an Introduction and a Methods section which includes the definitions and explanations of the epidemiological terms used, and comparisons of international patterns and trends in prostate cancer incidence, survival, prevalence and mortality. Part II of the review concentrates on detailed results for individual countries and includes the Discussion.

Trends in testicular carcinoma in England and Wales, 1971-99

Objectives To examine incidence, mortality and survival trends in England and Wales for testicular cancer, using the recently developed national cancer and national mortality databases.

Trends in prostate cancer incidence, mortality and survival in England and Wales 1971-1998.

Objectives To examine trends in prostate cancer incidence and mortality in England and Wales between 1971 and 1998, using a newly developed and validated national cancer database and the national mortality database.

Trends in oesophageal and gastric cancer incidence, mortality and survival in England and Wales 1971–1998/1999

Background : In England and Wales, 7% of cancers diagnosed in 1997 were oesophageal or gastric cancer.

Trends in the subsite and morphology of oesophageal and gastric cancer in England and Wales 1971-1998.

Background : The incidence of adenocarcinoma of the oesophagus and gastric cardia has increased in many countries.