Whittemore A S
Stanford University School of Medicine, Department of Health, Research and Policy, California 94305.
Cancer Surv. 1994;19-20:309-22.
Trends in prostate cancer incidence and mortality are examined for men in England, Italy, Japan, Sweden and the USA. Incidence rose during the period 1968-1972 to 1983-1987 in all these populations. A substantial portion of this increase may be due to increased detection rates. However, mortality also has risen during this period in most of the populations. Although some of the increased mortality may be due to changes in death certification, the possibility of real increases in incidence of aggressive disease cannot be excluded. Large international and interethnic differences are evident for both incidence and mortality, in all time periods. Interpretation of the differences in incidence is complicated by international and interethnic differences in detection rates. The differences in mortality are unlikely to be due entirely to differences in death certification. The temporal rise in incidence demonstrated by all these populations suggests worldwide increases in health care costs for prostate cancer. Since a large part of the increased incidence seems to be due to increased detection rates of localized disease that would otherwise have remained asymptomatic, the increased costs may not be associated with concomitant reductions in morbidity and mortality.
对英格兰、意大利、日本、瑞典和美国男性的前列腺癌发病率和死亡率趋势进行了研究。在1968 - 1972年至1983 - 1987年期间，所有这些人群的发病率均有所上升。这种上升的很大一部分可能归因于检测率的提高。然而，在此期间，大多数人群的死亡率也有所上升。虽然部分死亡率上升可能是由于死亡证明的变化，但侵袭性疾病发病率实际上升的可能性也不能排除。在所有时间段内，发病率和死亡率在国际和种族间都存在明显差异。检测率的国际和种族差异使发病率差异的解读变得复杂。死亡率的差异不太可能完全归因于死亡证明的差异。所有这些人群发病率的时间上升表明，全球前列腺癌医疗保健成本在增加。由于发病率增加的很大一部分似乎是由于局部疾病检测率的提高，否则这些疾病可能仍无症状，因此增加的成本可能与发病率和死亡率的相应降低无关。
