Andersen Marc Casper Meineche, Stroomberg Hein Vincent, Brasso Klaus, Helgstrand John Thomas, Røder Andreas
Copenhagen Prostate Cancer Center, Department of Urology, Copenhagen University Hospital, Rigshospitalet, 2200 Copenhagen, Denmark.
Department of Clinical Medicine, University of Copenhagen, 2200 Copenhagen, Denmark.
Diagnostics (Basel). 2022 May 19;12(5):1271. doi: 10.3390/diagnostics12051271.
The impact of changes in diagnostic activity and treatment options on prostate cancer epidemiology remains a subject of debate. Newly published long-term survival outcomes may not represent contemporary patients and new perspectives are in demand. All men dying in Denmark with prostate cancer diagnosis during a 10-year period were analyzed to address the stage migration of and time lived with prostate cancer diagnosis. All male deaths in Denmark between 2007 and 2016 ( = 261,657) were obtained and crosslinked with The Danish Prostate Cancer Registry (DaPCaR) and the Danish Cancer Registry. Correlation in diagnostic age and stage (localized, locally advanced, metastatic), age at death and cause of death were investigated by Kruskal-Wallis test and linear regression in 15,692 men diagnosed with prostate cancer. Prostate cancer mortality remained stable during the study period. Among the men who died of prostate cancer, 65% had locally advanced or metastatic disease at diagnosis. Age at diagnosis declined in men diagnosed with localized disease and remained constant in men with locally advanced or metastatic disease. Age at death increased in all men. Despite increased efforts to detect prostate cancer early, two-thirds of men who die from prostate cancer still have advanced prostate cancer at the time of diagnosis. Our data show increased life-expectancy in men diagnosed with prostate cancer, however, this benefit must be weighed against increased time of living with the disease and overdiagnosis. The intensified treatment of elderly men and men with advanced disease may be the key to lower prostate cancer mortality.
诊断活动和治疗方案的变化对前列腺癌流行病学的影响仍是一个有争议的话题。新发表的长期生存结果可能无法代表当代患者，因此需要新的视角。对丹麦在10年期间所有诊断为前列腺癌并死亡的男性进行分析，以探讨前列腺癌诊断的分期迁移和生存时间。获取了2007年至2016年丹麦所有男性死亡病例（n = 261,657），并将其与丹麦前列腺癌登记处（DaPCaR）和丹麦癌症登记处进行交叉比对。通过Kruskal-Wallis检验和线性回归，对15,692例诊断为前列腺癌的男性的诊断年龄和分期（局限性、局部晚期、转移性）、死亡年龄和死因之间的相关性进行了研究。在研究期间，前列腺癌死亡率保持稳定。在死于前列腺癌的男性中，65%在诊断时患有局部晚期或转移性疾病。诊断为局限性疾病的男性的诊断年龄下降，而局部晚期或转移性疾病的男性的诊断年龄保持不变。所有男性的死亡年龄均有所增加。尽管早期检测前列腺癌的力度加大，但三分之二死于前列腺癌的男性在诊断时仍患有晚期前列腺癌。我们的数据显示，诊断为前列腺癌的男性的预期寿命有所增加，然而，这种益处必须与疾病生存时间的增加和过度诊断相权衡。对老年男性和晚期疾病男性加强治疗可能是降低前列腺癌死亡率的关键。
