Department of Urology, Hospital Virgen de las Nieves, Granada, Spain.
BJU Int. 2012 Dec;110(11 Pt B):E701-6. doi: 10.1111/j.1464-410X.2012.11504.x. Epub 2012 Sep 19.
What's known on the subject? and What does the study add? Prostate cancer (PCa) accounts for 12% of newly diagnosed cases of cancer in Europe. It is one of the most frequently diagnosed tumours in the developed world. Since the introduction of prostate specific antigen as a test for early detection of PCa, the rate of diagnosis has increased significantly and specific mortality has reduced in most western countries. Most of the data on the incidence of PCa are obtained from population-based cancer registries which frequently do not cover the whole population. This first national hospital-based PCa registry aims not only to estimate the incidence of the disease but to ascertain the clinical profile of newly diagnosed PCa patients, a useful tool for evaluating the impact of the disease and its socio-health management.
• To estimate the 2010 incidence of prostate cancer (PCa) in Spain. • To describe the clinical profile of newly diagnosed cases using a nationwide hospital-based registry.
• This was a national epidemiological observational study in 25 public hospitals with a specific reference population according to the National Health System. • Sociodemographic and clinical variables of all newly diagnosed, histopathologically confirmed PCa cases were collected in 2010, in the area of influence of each centre. Cases diagnosed in private practice were not collected (estimated nearly 10% in Spain). • Data monitoring was external to guarantee quality and homogeneity. • The age-standardized PCa incidence was determined based on the age distribution of the European standard population.
• In all, 4087 new cases of PCa were diagnosed for a reference population of 4933940 men (21.8% of the Spanish male population). • The estimated age-standardized PCa incidence was 70.75 cases per 100000 men. • Mean age at diagnosis was 69 years; 11.6% of patients presented with tumour-related symptoms and 39.5% with LUTS. Median PSA was 8 ng/mL. Gleason score was ≤ 6 in 56.5%, 7 in 26.7% and >7 in 16.8% of patients. At diagnosis, 89.8% had localized, 6.4% locally advanced and 3.8% metastatic disease.
• This study on PCa incidence in Spain, a western country with intensive opportunistic PSA screening, shows that PCa is a high incidence tumour, diagnosed close to 70 years, usually asymptomatic. • Almost 40% of cases have low risk disease with a risk of over-diagnosis and over-treatment. • Around 55% of patients with intermediate or high risk disease are candidates for active therapy which may result in a reduction of cancer-specific mortality.
估计 2010 年西班牙前列腺癌（PCa）的发病率。
使用全国性基于医院的登记处描述新诊断病例的临床特征。
这是一项在 25 家公立医院进行的全国性流行病学观察研究，这些医院根据国家卫生系统有特定的参考人群。
2010 年，在每个中心的影响范围内收集了所有新诊断的、组织病理学证实的 PCa 病例的社会人口统计学和临床变量。未收集私人执业中诊断的病例（估计在西班牙约占 10%）。
数据监测是外部的，以保证质量和同质性。
根据欧洲标准人口的年龄分布，确定年龄标准化的 PCa 发病率。
共有 4087 例新诊断的 PCa，参考人群为 4933940 名男性（占西班牙男性人口的 21.8%）。
估计的年龄标准化 PCa 发病率为每 100000 名男性 70.75 例。
诊断时的平均年龄为 69 岁；11.6%的患者有肿瘤相关症状，39.5%有 LUTS。中位 PSA 为 8ng/mL。Gleason 评分≤6 的患者占 56.5%，7 的患者占 26.7%，>7 的患者占 16.8%。诊断时，89.8%的患者为局限性疾病，6.4%为局部进展性疾病，3.8%为转移性疾病。
这项关于西班牙前列腺癌发病率的研究，在一个有密集机会性 PSA 筛查的西方国家，表明前列腺癌是一种高发病率的肿瘤，诊断接近 70 岁，通常无症状。
近 40%的病例为低危疾病，存在过度诊断和过度治疗的风险。
约 55%的中高危疾病患者是积极治疗的候选者，这可能会降低癌症特异性死亡率。
