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International Trends in Prostate-Cancer Mortality in the "PSA ERA"

Oliver, S.E., May, M.T. and Gunnell, D. (2001) International Trends in Prostate-Cancer Mortality in the "PSA ERA". International Journal of Cancer, 92 (6). pp. 893-898. ISSN 0020-7136

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Incidence and mortality from prostate cancer were rising in most countries until the late 1980s. Following a number of advances in the management of prostate cancer, including introduction of the prostate-specific antigen (PSA) test, there have been reports of declines in mortality in Canada, the United States and the United Kingdom. To investigate the extent to which this pattern was seen in other industrialised countries, we used routinely collected data to explore recent changes in prostate-cancer mortality. Trends in age-standardised death rates between 1979 and 1997 for men aged 50 to 79 years in 24 industrialised countries were compared using join point regression. Join point regression allows estimation of the annual percentage change in death rates and tests for significant changes in trend. During the period studied, age-standardised mortality increased at 1% to 2% per year in most countries. In 7 countries (Canada, United States, Austria, France, Germany, Italy and United Kingdom), a significant down-turn in age-standardised mortality was observed over the period 1988-1991. Trends in age-specific rates within these countries support a period effect on prostate-cancer mortality. Declines in mortality could result from any combination of either artefact, reduction in prostate-cancer incidence, a rise in competing causes of death or changes in the risk of death from prostate cancer. There are inconsistencies in the relationship between national mortality trends and uptake of PSA screening; further research is required to determine whether changes in death rates can be explained by international and secular variations in the treatment of prostate cancer.

Item Type: Article
Keywords: prostatic neoplasm; mortality; prostate-specific antigen; time trends; epidemiology
Institution: The University of York
Academic Units: The University of York > Hull York Medical School (York)
Depositing User: York RAE Import
Date Deposited: 11 Jun 2009 12:47
Last Modified: 11 Jun 2009 12:47
Published Version: http://dx.doi.org/10.1002/ijc.1260
Status: Published
Publisher: John Wiley & Sons, Ltd
Refereed: Yes
Identification Number: 10.1002/ijc.1260
URI: http://eprints.whiterose.ac.uk/id/eprint/6353

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