Cancer Information Section, International Agency for Research on Cancer, Lyon, France.
Eur J Cancer. 2010 Nov;46(17):3040-52. doi: 10.1016/j.ejca.2010.09.013.
Prostate cancer has emerged as the most frequent cancer amongst men in Europe, with incidence increasing rapidly over the past two decades. Incidence has been uniformly increasing in the 24 countries with comparable data available, although in a few countries with very high rates (Sweden, Finland and The Netherlands), incidence has begun to fall during the last 3-4 years. The highest prostate cancer mortality rates are in the Baltic region (Estonia, Latvia and Lithuania) and in Denmark, Norway and Sweden. Prostate cancer mortality has been decreasing in 13 of the 37 European countries considered - predominantly in higher-resource countries within each region - beginning in England and Wales (1992) and more recently in the Czech Republic (2004). There was considerable variability in the magnitude of the annual declines, varying from approximately 1% in Scotland (from 1994) to over 4% for the more recent declines in Hungary, France and the Czech Republic. There appears little relation between the extent of the increases in incidence (in the late 1990s) and the recent mortality declines. It remains unclear to what extent the increasing trends in incidence indicate true risk and how much is due to detection of latent disease. The decreasing mortality after 1990 may be attributable to improvements in treatment and to an effect of prostate specific antigen (PSA) testing. The increase in mortality observed in the Baltic region and in several Central and Eastern European countries appear to reflect a real increase in risk and requires further monitoring.
在欧洲，前列腺癌已成为男性最常见的癌症，在过去的二十年中，其发病率迅速上升。在有可比数据的 24 个国家中，发病率一直在普遍上升，尽管在一些发病率非常高的国家（瑞典、芬兰和荷兰），发病率在过去 3-4 年内开始下降。波罗的海地区（爱沙尼亚、拉脱维亚和立陶宛）以及丹麦、挪威和瑞典的前列腺癌死亡率最高。在考虑的 37 个欧洲国家中，有 13 个国家的前列腺癌死亡率一直在下降——主要是在每个地区资源更丰富的国家——始于英格兰和威尔士（1992 年），最近在捷克共和国（2004 年）也是如此。每年下降幅度的差异很大，从苏格兰的约 1%（从 1994 年开始）到匈牙利、法国和捷克共和国最近的下降幅度超过 4%。发病率的上升幅度（在 20 世纪 90 年代末）与最近死亡率的下降之间似乎没有什么关系。目前尚不清楚发病率的上升趋势在多大程度上表明了真正的风险，以及有多少是由于潜伏疾病的检测。1990 年后死亡率的下降可能归因于治疗的改善和前列腺特异性抗原（PSA）检测的影响。波罗的海地区和几个中东欧国家观察到的死亡率上升似乎反映了风险的真实上升，需要进一步监测。
