Department of Clinical- and Registry-based Research, Cancer Registry of Norway, Majorsteuen, Oslo, Norway.
Acta Oncol. 2010 Jun;49(5):644-54. doi: 10.3109/02841860903575315.
BACKGROUND: Prostate, testicular and penile cancer constitute about one-third of the cancer incidence burden among Nordic males, but less than one-fifth of the corresponding mortality. The aim of this study is to describe and interpret trends in relative survival and excess mortality in the five Nordic populations. MATERIAL AND METHODS: Age-standardised incidence and mortality rates, 5-year relative survival, and excess mortality rates for varying follow-up periods are presented, as are age-specific 5-year relative survival by country, sex and 5-year diagnostic period. RESULTS: The vast majority of male genital cancer incident cases and deaths are prostate cancers, with 5-year and 10-year survival trends resembling the diagnostic-led increasing incidence over the past 25 years. Five-year prostate cancer survival is estimated at 53% in Denmark compared to 78% or above in the other Nordic populations for patients diagnosed 1999-2003. Excess mortality has declined over time, with Denmark having a greater excess of deaths compared to the other countries, irrespective of time of diagnosis. Concomitant with the declines in testicular cancer mortality, testicular cancer survival has increased since the 1970s in each Nordic country. Men diagnosed with testicular cancer in recent decades have had, on average, a continually better prognosis with time, with relative 5-year survival for patients diagnosed 1999-2003 ranging from 88% in Finland to 94% in Sweden. For the few patients diagnosed with cancer of the penis and other male genital organs, survival trends have been rather stable over time, with recent 5-year relative survival estimates ranging from 62% in Finland to 80% in Norway. CONCLUSIONS: There are intriguing country-specific and temporal variations in male genital cancer survival in the Nordic countries. Prognosis varies widely by cancer site and relates to both changing diagnostic and clinical practices. The increasing PSA detection and biopsy makes interpretation of the prostate cancer survival trends particularly difficult.
背景：前列腺癌、睾丸癌和阴茎癌约占北欧男性癌症发病率的三分之一，但死亡率不到五分之一。本研究的目的是描述和解释北欧五国相对生存率和超额死亡率的趋势。
材料和方法：呈现了年龄标准化的发病率和死亡率、5 年相对生存率以及不同随访期的超额死亡率，还呈现了按国家、性别和 5 年诊断期划分的年龄特异性 5 年相对生存率。
结果：绝大多数男性生殖器官癌症的发病和死亡病例为前列腺癌，5 年和 10 年的生存率趋势与过去 25 年来诊断相关的发病率上升相似。1999-2003 年诊断的患者中，丹麦的 5 年前列腺癌生存率估计为 53%，而其他北欧国家则为 78%或更高。随着时间的推移，超额死亡率有所下降，丹麦的死亡超额人数无论诊断时间如何，都高于其他国家。随着睾丸癌死亡率的下降，自 20 世纪 70 年代以来，每个北欧国家的睾丸癌生存率都有所提高。近几十年来被诊断患有睾丸癌的男性，随着时间的推移，平均预后不断改善，1999-2003 年诊断的患者的 5 年相对生存率从芬兰的 88%到瑞典的 94%不等。对于少数被诊断患有阴茎癌和其他男性生殖器官癌症的患者，生存率趋势随时间相对稳定，最近的 5 年相对生存率估计从芬兰的 62%到挪威的 80%不等。
结论：在北欧国家，男性生殖器官癌症的生存率存在有趣的国家特异性和时间变化。预后因癌症部位而异，与不断变化的诊断和临床实践有关。PSA 检测和活检的增加使得对前列腺癌生存率趋势的解释变得特别困难。
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