Adult Chronic Diseases and Conditions Division, Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ontario.
Health Rep. 2019 Apr 17;30(4):12-17. doi: 10.25318/82-003-x201900400002-eng.
Prostate cancer is the most common type of cancer in Canadian men. Screening recommendations have changed substantially over the last 25 years. Since 2011 (United States) and 2014 (Canada), taskforce guidelines have recommended against screening using the prostate-specific antigen (PSA) test in low-risk men of all ages. This work reports on trends in prostate cancer incidence, mortality, and stage at diagnosis in Canada from 1992 to 2015.
Prostate cancer incidence, mortality, and stage at diagnosis were retrieved from Statistics Canada's Canadian Cancer Registry and Canadian Vital Statistics - Death Database. Joinpoint analysis was used to examine trends over time.
The age-standardized incidence rate (ASIR) of prostate cancer peaked in 1993 and 2001, and declined thereafter. From 2011 to 2015, the ASIR declined by 9.3% per year. The age-standardized mortality rate (ASMR) decreased continuously from 1992 to 2015, but fell most rapidly (2.9% per year) after 2001. Data from two provinces show that, from 2005 to 2015, the rate of Stage I and Stage II cancers decreased by 3.2% per year, while the rate of Stage III and Stage IV cancers remained relatively stable.
Incidence of prostate cancer has declined substantially in recent years. Most of the decline seems to be in localized cases (Stage I and Stage II). Changes in incidence have mirrored changes to PSA screening recommendations. Future work should continue to monitor trends over time at the national level, especially as they relate to screening recommendations.
前列腺癌是加拿大男性最常见的癌症类型。在过去的 25 年中，筛查建议发生了重大变化。自 2011 年（美国）和 2014 年（加拿大）以来，专家组指南建议在所有年龄段的低危男性中避免使用前列腺特异性抗原（PSA）检测进行筛查。这项工作报告了 1992 年至 2015 年加拿大前列腺癌发病率、死亡率和诊断时分期的趋势。
前列腺癌发病率、死亡率和诊断时分期从加拿大统计局的加拿大癌症登记处和加拿大生命统计-死亡数据库中检索。使用 Joinpoint 分析来检查随时间的趋势。
前列腺癌的年龄标准化发病率（ASIR）在 1993 年和 2001 年达到峰值，此后呈下降趋势。从 2011 年到 2015 年，ASIR 每年下降 9.3%。年龄标准化死亡率（ASMR）从 1992 年持续下降到 2015 年，但在 2001 年后下降最快（每年 2.9%）。两个省份的数据表明，从 2005 年到 2015 年，I 期和 II 期癌症的发病率每年下降 3.2%，而 III 期和 IV 期癌症的发病率保持相对稳定。
近年来，前列腺癌的发病率已大幅下降。大部分下降似乎发生在局部病例（I 期和 II 期）。发病率的变化反映了 PSA 筛查建议的变化。未来的工作应继续在国家层面上监测随时间的趋势，特别是与筛查建议有关的趋势。
