Inghelmann Riccardo, Grande Enrico, Francisci Silvia, Verdecchia Arduino, Micheli Andrea, Baili Paolo, Gatta Gemma, Capocaccia Riccardo, Valdagni Riccardo, De Angelis Roberta
Reparto di Epidemiologia dei Tumori, Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Istituto Superiore di Sanità, Rome, Italy.
Tumori. 2007 Jul-Aug;93(4):380-6. doi: 10.1177/030089160709300409.
Prostate cancer is one of the most common cancers in developed countries and the most common among men in industrialized countries. The introduction of new diagnostic procedures caused an increase in new diagnoses in Italy starting from the early 1990s, while the prognosis of prostate cancer improved due to the use of hormonal treatments. The aim of this paper is to present estimates of prostate cancer mortality, incidence and prevalence over the period 1970-2005 for the Italian regions and for Italy as a whole, and to assess the changes that opportunistic screening and the diffusion of more effective treatments introduced.
Estimated figures for incidence, prevalence and mortality were obtained with the MIAMOD method. Starting from the knowledge of mortality in the period 1970-1999 and of the relative survival in the period of diagnosis 1978-1994, we derived incidence and prevalence estimates up to the year 2005 by means of a statistical back-calculation approach. Survival at regional and national levels was modelled on the basis of published survival data from the Italian cancer registries.
The incidence trend showed a steep increase all over the country during the entire estimation period 1970-2005 with a more pronounced increase in the Center-North then in the South of Italy. Incidence of northern and central regions was about twice as high as that of southern regions. Mortality trends were however constant or declining in the majority of northern-central regions, while they still increased in the South. A total of around 43,000 incident cases, 174,000 prevalent cases and 9,000 deaths were estimated for Italy in 2005.
The effects of opportunistic screening are reflected in an earlier diagnosis for many patients. The existing North-South gradient in incidence seems to be associated with the different spread of the PSA test in different parts of the country. Prostate cancer remains a great health problem in terms of both incidence and prevalence.
前列腺癌是发达国家最常见的癌症之一，在工业化国家的男性中最为普遍。自20世纪90年代初起，新诊断程序的引入致使意大利新诊断病例数增加，而由于激素治疗的应用，前列腺癌的预后有所改善。本文旨在呈现1970 - 2005年期间意大利各地区及整个意大利的前列腺癌死亡率、发病率和患病率估计值，并评估机会性筛查及更有效治疗方法的普及所带来的变化。
采用MIAMOD方法获取发病率、患病率和死亡率的估计数据。基于1970 - 1999年期间的死亡率以及1978 - 1994年诊断期间的相对生存率，我们通过统计反向计算方法得出截至2005年的发病率和患病率估计值。区域和国家层面的生存率是根据意大利癌症登记处公布的生存数据进行建模的。
在1970 - 2005年整个估计期间，发病率趋势在全国范围内呈急剧上升态势，意大利中北部的上升更为显著，随后是南部地区。北部和中部地区的发病率约为南部地区的两倍。然而，大多数中北部地区的死亡率趋势保持稳定或下降，而南部地区仍在上升。2005年意大利估计共有约43,000例新发病例、174,000例现患病例和9,000例死亡病例。
机会性筛查的效果体现在许多患者得到了更早的诊断。现有的发病率南北梯度差异似乎与前列腺特异性抗原（PSA）检测在该国不同地区的不同普及程度有关。就发病率和患病率而言，前列腺癌仍然是一个重大的健康问题。
