Prostate cancer treatment in Europe at the end of 1990s

• Published in: Acta oncologica Vol. 48; no. 6; pp. 867 - 873
• Main Authors: Gatta, Gemma, Zigon, Giulia, Buemi, Antoine, Coebergh, Jan Willem, Colonna, Marc, Contiero, Paolo, Denis, Louis, Grosclaude, Pascale, Guizard, Ann Valèrie, Sanchez-Perez, Maria Jose, Plesko, Ivan, Ondrusova, Martina, Rachtan, Jadwiga, Valdagni, Riccardo, Velten, Michael, Vercelli, Marina, Berrino, Franco
• Format: Journal Article
• Language: English
• Published: England Informa UK Ltd 01.01.2009; Taylor & Francis
• Subjects: Age Factors; Age of Onset; Aged; Aged, 80 and over; Combined Modality Therapy; Europe - epidemiology; Humans; Life Sciences; Male; Middle Aged; Prognosis; Prostatectomy; Prostatic Neoplasms - epidemiology; Prostatic Neoplasms - therapy; Radiotherapy; Registries; Santé publique et épidémiologie; Europe
• ISSN: 0284-186X; 1651-226X
• DOI: 10.1080/02841860902719174

Background. There is wide variation in prostate cancer incidence and survival across Europe. In many countries incidence is rising sharply in relation to the introduction of prostate-specific antigen assay, and there is concern that patients may not be treated appropriately. We therefore aimed to characterize treatment for prostate cancer across Europe. Methods. We performed a high resolution population-based study, collecting information on the treatment of 3 486 prostate cancer cases diagnosed in 1995-1999 in 11 cancer registries from six European countries. Results. Overall, about one in three patients received radical treatment (prostatectomy 23% or radiotherapy 14%); about 60% of younger patients (<70 years) received radical treatment, while a similar proportion of older patients (≥70 years) received palliation (transurethral prostatectomy or hormone treatment only). A considerable proportion (61%) of patients with apparently high-risk disease were treated radically within a year of diagnosis, with large variation between regions: >70% in Calvados, Haut-Rhin, Tarn and Eindhoven and <50% in Slovakia and Cracow. Overall 34% of patients with apparently low-risk disease received radical treatment, varying from 17% and 22% in Bas-Rhin and Granada, to 52% and 56% in Calvados and Eindhoven. Conclusions. Our data indicate wide variation in the treatment for prostate cancer even among patients with apparently similar disease, and further suggest a non-negligible proportion may be receiving inappropriate radical treatment for apparently low-risk disease. Current guidelines indicate active surveillance should become the main means of managing low-risk disease.