A new analysis by the International Agency for Research on Cancer offers an update on the incidence and mortality rates associated with prostate cancer in Europe over the past 20 years.
According to the new article by Bray et al., the incidence of prostate cancer has been consistently increasing in the 24 countries for which directly comparable data are available. However, there are a small number of nations (Sweden, Finland and The Netherlands) with historically high incidence rates where incidence has has begun to fall in the most recent time period.
Baltic and Scandinavian nations (Estonia, Latvia, Lithuania, Denmark, Norway, and Sweden) appear to have the highest rates of prostate cancer mortality. However, mortality rates have been dropping in 13 of the 37 European countries considered by Bray et al. This decline in the mortality rates appears to be directly related to the health and medical resources available that can be dedicated to prostate cancer diagnosis and management.
Declines in mortality rates vary from about 1 percent per year in Scotland (since 1994) to over 4 percent per year for more recent declines in Hungary, France and the Czech Republic. There appears little relation between the extent of the increases in incidence (in the late 1990s) and the recent mortality declines. It also seems to be unclear whether increasing incidence is a reflection of an increase in true risk or increasing detection of latent disease.
The authors state that decreasing mortality after 1990 may be attributable to improvements in treatment and to the effects of more extensive use of PSA testing. However, they note that the increase in mortality observed in the Baltic region and in several Central and Eastern European countries appears to reflect a real increase in risk and requires further monitoring. This increase in true risk may be associated with an increase in male life expectancy in some of these countries.