Etxeberria J, Guevara M, Moreno-Iribas C, Burgui R, Delfrade I, Floristán Y, Montesino M, Ardanaz E
.
An Sist Sanit Navar. 2018 Apr 30;41(1):9-15. doi: 10.23938/ASSN.0123.
Prostate cancer is one of the most commonly diagnosed malignancies among males worldwide. In this study, overall and age-specific incidence and mortality trends are analyzed in order to present the past and current epidemiological situation of the disease in Navarre (Spain).
Population-based incidence data from the 1975-2010 period, provided by the Cancer Registry of Navarre and prostate cancer specific mortality data for 1975-2013, provided by the Spanish Statistical Office, were used in the analysis. Age-standardized incidence and mortality rates, change-points and annual percentage changes (APC) were estimated by joinpoint regression analysis. One-dimensional P-spline models were used to estimate projections up to 2016.
Considerable increases of cancer incidence rates in men aged 45-74 years were observed, with APC of +4.5% (p<0.001), +9.5% (p<0.001) and +2.4% (p<0.05) in the 1975-1990, 1990-2000 and 2000-2010 periods, respectively. In the older than 74 age-group, an increase of incidence rates in the 1975-1999 period was registered (APC +3.3%, p<0.001), followed by a significant decrease up to 2010 (APC -4.0%, p<0.01). Mortality rates rose until 1995 (APC +2.2%, p<0.001) whereas a decline occurred afterwards up to 2013 (APC -3.4%, p<0.001).
Even though overall prostate cancer incidence rates seem to have stabilized in 2002-2010 in Navarra, trends were different by age groups: increased in men 45-74 years old and decreased in the 75+ year age-group. A decline in mortality rates was observed in both age groups since about 1995. Changes in the use of prostate specific antigen test for screening in oncoming years could affect future prostate cancer trends.
前列腺癌是全球男性中最常被诊断出的恶性肿瘤之一。在本研究中,分析了总体及特定年龄的发病率和死亡率趋势,以呈现西班牙纳瓦拉地区该疾病过去和当前的流行病学情况。
分析使用了由纳瓦拉癌症登记处提供的1975 - 2010年基于人群的发病率数据,以及由西班牙统计局提供的1975 - 2013年前列腺癌特异性死亡率数据。通过连接点回归分析估计年龄标准化发病率和死亡率、变化点及年度百分比变化(APC)。使用一维P样条模型估计至2016年的预测值。
观察到45 - 74岁男性的癌症发病率显著上升,在1975 - 1990年、1990 - 2000年和2000 - 2010年期间的APC分别为 +4.5%(p<0.001)、+9.5%(p<0.001)和 +2.4%(p<0.05)。在74岁以上年龄组,1975 - 1999年期间发病率上升(APC +3.3%,p<0.001),随后到2010年显著下降(APC -4.0%,p<0.01)。死亡率在1995年之前上升(APC +2.2%,p<0.001),而此后到2013年下降(APC -3.4%,p<0.001)。
尽管在纳瓦拉地区2002 - 2010年期间总体前列腺癌发病率似乎已稳定,但各年龄组趋势不同:45 - 74岁男性发病率上升,75岁及以上年龄组发病率下降。自1995年左右以来,两个年龄组的死亡率均下降。未来几年前列腺特异性抗原检测用于筛查的使用变化可能会影响未来前列腺癌趋势。