Kvåle Rune, Auvinen Anssi, Adami Hans-Olov, Klint Asa, Hernes Eivor, Møller Bjørn, Pukkala Eero, Storm Hans H, Tryggvadottir Laufey, Tretli Steinar, Wahlqvist Rolf, Weiderpass Elisabete, Bray Freddie
The Cancer Registry of Norway, 0310 Oslo, Norway.
J Natl Cancer Inst. 2007 Dec 19;99(24):1881-7. doi: 10.1093/jnci/djm249. Epub 2007 Dec 11.
Trends in incidence and mortality rates of prostate cancer were analyzed using data from the national cancer registries of Denmark, Finland, Iceland, Norway, and Sweden. Joinpoint regression models were used to quantify temporal trends for the period from 1980 to 2004. Incidence rates were increasing and similar in the Nordic countries during the 1980s. Around 1990, a more rapid incidence increase began in all Nordic countries except Denmark, where an increase was seen 5 years later. In 2001, incidence rates in Denmark were half of those seen in the other Nordic countries, but mortality rates varied only marginally among countries. Mean annual declines in prostate cancer mortality of 1.9% (95% CI = 0.4% to 3.3%) and 1.8% (95% CI = 0.5% to 3.0%) were observed from 1996 to 2004 in Finland and Norway, respectively. During the same period, mortality rates leveled off in Iceland and Sweden but continued to increase in Denmark. The rapid increase in incidence during the early 1990s coincided with the introduction of the prostate-specific antigen (PSA) test and conveys little information about the occurrence of potentially lethal disease. Mortality rates, however, have recently stabilized or declined in countries where PSA testing and curative treatment have been commonly practiced since the late 1980s. Although other explanatory factors may be in operation, these trends are consistent with a moderate effect of increased curative treatment of early diagnosed prostate cancer and improved treatment of more advanced disease.
利用丹麦、芬兰、冰岛、挪威和瑞典国家癌症登记处的数据，分析了前列腺癌的发病率和死亡率趋势。采用连接点回归模型量化1980年至2004年期间的时间趋势。20世纪80年代，北欧国家的发病率呈上升趋势且相似。1990年左右，除丹麦外，所有北欧国家的发病率开始更快上升，丹麦的发病率在5年后才出现上升。2001年，丹麦的发病率是其他北欧国家的一半，但各国的死亡率仅略有差异。1996年至2004年期间，芬兰和挪威的前列腺癌死亡率分别平均每年下降1.9%（95%可信区间=0.4%至3.3%）和1.8%（95%可信区间=0.5%至3.0%）。同期，冰岛和瑞典的死亡率趋于平稳，但丹麦的死亡率继续上升。20世纪90年代初发病率的快速上升与前列腺特异性抗原（PSA）检测的引入同时发生，几乎没有传达有关潜在致命疾病发生情况的信息。然而，在自20世纪80年代末以来普遍开展PSA检测和根治性治疗的国家，死亡率最近已趋于稳定或下降。尽管可能还有其他解释因素在起作用，但这些趋势与早期诊断前列腺癌的根治性治疗增加和更晚期疾病治疗改善的适度效果一致。
