Varenhorst Eberhard, Garmo Hans, Holmberg Lars, Adolfsson Jan, Damber Jan-Erik, Hellström Magnus, Hugosson Jonas, Lundgren Rolf, Stattin Pär, Törnblom Magnus, Johansson Jan-Erik
Department of Urology, Faculty of Health Sciences, University Hospital Linköping, Linköping, Sweden.
Scand J Urol Nephrol. 2005;39(2):117-23. doi: 10.1080/00365590510007793.
To provide a descriptive review of the establishment of the National Prostate Cancer Register (NPCR) in Sweden, to present clinical characteristics at diagnosis and to calculate the relative survival of different risk groups after 5 years.
Since 1998, data on all newly diagnosed prostate cancers, including TNM classification, grade of malignancy, prostate-specific antigen (PSA) level and treatment, have been prospectively collected. For the 35,223 patients diagnosed between 1998 and 2002, relative survival in different risk groups has been calculated.
Between 1998 and 2002, 96% of all prostate cancer cases diagnosed in Sweden were registered in the NPCR. The number of new cases increased from 6137 in 1998 to 7385 in 2002. The age-standardized rate rose in those aged < 70 years, while it was stable, or possibly declining from 1999, in the older age groups. The proportion of T1c tumours increased from 14% to 28% of all recorded cases. The age-adjusted incidence of advanced tumours (M1 or PSA > 100 ng/ml) decreased by 17%. The proportion of patients receiving curative treatment doubled. Patients with N1 or M1 disease or poorly differentiated tumours (G3 or Gleason score 8-10) had a markedly reduced relative 5-year survival rate.
It is possible to establish a nationwide prostate cancer register including basic data for assessment of the disease in the whole of Sweden. The introduction of PSA screening has increased the detection of early prostate cancer in younger men and, to a lesser extent, decreased the incidence of advanced disease. The effect of these changes on mortality is obscure but the NPCR in Sweden will serve as an important tool in such evaluation.
对瑞典国家前列腺癌登记处（NPCR）的建立进行描述性综述，呈现诊断时的临床特征，并计算不同风险组5年后的相对生存率。
自1998年起，前瞻性收集所有新诊断前列腺癌的数据，包括TNM分类、恶性程度分级、前列腺特异性抗原（PSA）水平及治疗情况。对于1998年至2002年间诊断的35223例患者，计算了不同风险组的相对生存率。
1998年至2002年间，瑞典诊断的所有前列腺癌病例中有96%登记在NPCR中。新病例数从1998年的6137例增加到2002年的7385例。年龄标准化发病率在70岁以下人群中上升，而在老年人群中保持稳定，或自1999年起可能有所下降。T1c肿瘤的比例从所有记录病例的14%增加到28%。晚期肿瘤（M1或PSA>100 ng/ml）的年龄调整发病率下降了17%。接受根治性治疗的患者比例翻倍。N1或M1疾病患者或低分化肿瘤（G3或Gleason评分8 - 10）的5年相对生存率显著降低。
在瑞典建立一个包括全国前列腺癌基础数据的登记处是可行的，这有助于评估全国范围内的疾病情况。PSA筛查的引入增加了年轻男性早期前列腺癌的检出率，并在一定程度上降低了晚期疾病的发病率。这些变化对死亡率的影响尚不清楚，但瑞典的NPCR将成为此类评估的重要工具。
