An examination of prostate cancer trends in Australia, England, Canada and USA: Is the Australian death rate too high?

Abstract

Purpose To compare prostate cancer incidence and mortality rates in Australia, USA, Canada and England and quantify the gap between observed prostate cancer deaths in Australia and expected deaths, using US mortality rates.Methods Analysis of age-standardised prostate cancer incidence and mortality rates, using routinely available data, in four similarly developed countries and joinpoint regression to quantify the changing rates (annual percentage change: APC) and test statistical significance. Expected prostate cancer deaths, using US mortality rates, were calculated and compared with observed deaths in Australia (1994–2010).ResultsIn all four countries, incidence rates initially peaked between 1992 and 1994, but a second, higher peak occurred in Australia in 2009 (188.9/100,000), rising at a rate of 5.8 % (1998–2008). Mortality rates in the USA (APC: −2.9 %; 2004–2010), Canada (APC: −2.9 %; 2006–2011) and England (APC: −2.6 %; 2003–2008) decreased at a faster rate compared with Australia (APC: −1.7 %; 1997–2011). In 2010, mortality rates were highest in England and Australia (23.8/100,000 in both countries). The mortality gap between Australia and USA grew from 1994 to 2010, with a total of 10,895 excess prostate cancer deaths in Australia compared with US rates over 17 preceding years.ConclusionsProstate cancer incidence rates are likely heavily influenced by prostate-specific antigen testing, but the fall in mortality occurred too soon to be solely a result of testing. Greater emphasis should be placed on addressing system-wide differences in the management of prostate cancer to reduce the number of men dying from this disease.

Evaluating two decision aids for Australian men supporting informed decisions about prostate cancer screening: A randomised controlled trial

“…[14,15,21] Our study was conducted in Australia, where the clinical context and uptake of screening using the PSA test is similar to that in the USA and Canada. [23] Our findings are therefore applicable and relevant to those jurisdictions. The percentage of men who achieved informed choice in this study is consistent with other DAs promoting informed choice internationally, including in the context of breast (15-24% of women) [11] and bowel screening (34%).…”

Microvascular density in prostate core biopsy: Prognostic predictors?

“…MVD se računala brojanjem CD105 pozitivnih struktura u 5 "vrućih tačaka". Nakon kvantitativne analize, stereometrijski je izračunata MVD po mm 2 . .Za statističku obradu dobijenih rezultata korišćen je programski paket SPSS (verzija 19.0).…”

“…Srednja vrednost CD 105 pozitivnih ćelija po mm 2 je značajno veća u PC nego kod BHP (676.6 vs 186.5). U PC postoji signifikantna povezanost MVD sa Gleason score (r=0.831) i nivoom PSA (r=0.343).…”

“…1 Bolest se najčešće javlja kod muškaraca starijih od 50 godina i praćena je značajnom stopom mortaliteta, koja se povećava sa produženjem životnog veka muškaraca u Evropi i svetu. 2 Najznačajniji faktori rizika za nastanak karcinoma prostate su starije životno doba, androgeni hormoni, pozitivna porodična anamneza, geografski položaj, gojaznost, socijalni i ekonomski uslovi. 3,4 Prema nekim istraživanjima povećani unos hrane bogate mastima i rafinisanim ugljenim hidratima takođe doprinose povećanju incidence oboljevanja u industrijski razvijenim zemljama.…”

Trends in urethral stricture management over two decades

“…The burden of disease from urethral strictures is expected to increase with time. Contributory factors include a rising incidence of prostate cancer in an ageing population, with use of radiotherapy and increasing utilisation of endoscopic vs open urological procedures for large‐volume BPH and urolithiasis .…”