Adolfsson Jan, Garmo Hans, Varenhorst Eberhard, Ahlgren Göran, Ahlstrand Christer, Andrén Ove, Bill-Axelson Anna, Bratt Ola, Damber Jan-Erik, Hellström Karin, Hellström Magnus, Holmberg Erik, Holmberg Lars, Hugosson Jonas, Johansson Jan-Erik, Petterson Bill, Törnblom Magnus, Widmark Anders, Stattin Pär
Oncological Centre, Karolinska University Hospital, CLINTEC, Karolinska Institute, Stockholm, Sweden.
Scand J Urol Nephrol. 2007;41(6):456-77. doi: 10.1080/00365590701673625.
The incidence of prostate cancer is rising rapidly in Sweden and there is a need to better understand the pattern of diagnosis, tumor characteristics and treatment.
Between 1996 and 2005, all new cases of adenocarcinoma of the prostate gland were intended to be registered in the National Prostate Cancer Register (NPCR). This register contains information on diagnosing unit, date of diagnosis, cause of diagnosis, tumor grade, tumor stage according to the TNM classification in force, serum prostate-specific antigen (PSA) levels at diagnosis and primary treatment given within the first 6 months after diagnosis.
In total, 72,028 patients were registered, comprising >97% of all pertinent incident cases of prostate cancer in the Swedish Cancer Register (SCR). During the study period there was a considerable decrease in median age at the time of diagnosis, a stage migration towards smaller tumors, a decrease in median serum PSA values at diagnosis, a decrease in the age-standardized incidence rate of men diagnosed with distant metastases or with a PSA level of > 100 ng/ml at diagnosis and an increase in the proportion of tumors with Gleason score <6. Relatively large geographical differences in the median age at diagnosis and the age-standardized incidence of cases with category T1c tumors were observed. Treatment with curative intent increased dramatically and treatment patterns varied according to geographical region. In men with localized tumors and a PSA level of <20 ng/ml at diagnosis, expectant treatment was more commonly used in those aged > or =75 years than in those aged <75 years. Also, the pattern of endocrine treatment varied in different parts of Sweden.
All changes in the register seen over time are consistent with increased diagnostic activity, especially PSA testing, resulting in an increased number of cases with early disease, predominantly tumors in category T1c. The patterns of diagnosis and treatment of prostate cancer vary considerably in different parts of Sweden. The NPCR continues to be an important source for research, epidemiological surveillance of the incidence, diagnosis and treatment of prostate cancer.
瑞典前列腺癌的发病率正在迅速上升，因此有必要更好地了解其诊断模式、肿瘤特征及治疗情况。
1996年至2005年间，所有前列腺腺癌新发病例均计划登记于国家前列腺癌登记处（NPCR）。该登记处包含有关诊断单位、诊断日期、诊断原因、肿瘤分级、根据现行TNM分类的肿瘤分期、诊断时的血清前列腺特异性抗原（PSA）水平以及诊断后前6个月内接受的初始治疗等信息。
总共登记了72028例患者，占瑞典癌症登记处（SCR）中所有相关前列腺癌新发病例的97%以上。在研究期间，诊断时的中位年龄显著下降，肿瘤分期向较小肿瘤转移，诊断时的血清PSA中位值下降，诊断时伴有远处转移或PSA水平>100 ng/ml的男性年龄标准化发病率下降，Gleason评分<6的肿瘤比例增加。观察到诊断时的中位年龄以及T1c类肿瘤病例的年龄标准化发病率存在较大的地理差异。根治性治疗显著增加，且治疗模式因地理区域而异。在诊断时肿瘤局限且PSA水平<20 ng/ml的男性中，75岁及以上患者比75岁以下患者更常采用观察等待治疗。此外，瑞典不同地区的内分泌治疗模式也有所不同。
登记处随时间出现的所有变化均与诊断活动增加一致，尤其是PSA检测，这导致早期疾病病例数量增加，主要是T1c类肿瘤。瑞典不同地区前列腺癌的诊断和治疗模式差异很大。NPCR仍然是前列腺癌发病率、诊断和治疗研究及流行病学监测的重要来源。
Zotero 插件