2024-09-09 04:00:23
How can we explain such differences in the incidence of prostate cancer in Europe? In France, this tumor is the most common in men (59,800 new cases in 2018, according to Public Health France) and the third leading cause of cancer death, after lung and colorectal cancer. In 2018, prostate cancer was the cause of 8,100 deaths, a number that has been falling by 3.7% per year since 2010.
A study published Wednesday, September 4 in the British Medical Journal shows an overall increase in the incidence rates of these tumors between 1980 and 2017, but in a fairly heterogeneous manner across the 26 countries studied.
Researchers from the International Agency for Research on Cancer (IARC)an agency of the World Health Organization, working with Chinese and European colleagues, compared incidence rates with screening and mortality rates. In each country, the incidence rate was positively correlated with screening practices – prostate-specific antigen (PSA) testing.
Early detection of risk factors
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Table of Contents
Ireland is the country with the highest incidence of prostate cancer: 287 per 100,000 men aged 35 to 84 in 2020. France is in fourth place (257). “The results of this study are consistent with significant overdiagnosis of prostate cancer resulting from opportunistic screening with PSA testing.”summarizes Salvatore Vaccarella, epidemiologist at IARC, who led the study.
However, despite the increase in cancer cases, mortality remains low, and has decreased slightly and homogeneously in all countries. “The variation in prostate cancer incidence rates between countries during the study period is much greater than that in mortality rates”says Salvatore Vaccarella. According to him, “the drop in mortality could be explained mainly by a gradual improvement in treatments.”
The debate surrounding screening for this cancer is not new. “The benefit of prostate cancer screening is not clearly demonstrated”, health authorities estimate, who do not recommend it in the general population. Early detection can be considered on an individual basis, for example in men with risk factors, such as being aged 50 or over with urinary symptoms, having a family history of prostate cancer or being of African or Afro-Caribbean origin.
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Studies (randomised clinical trials) in this area are contradictory: one of them, European, showed a reduction in the number of deaths after about ten years, while other randomised trials, such as “Prostate, Lung, Colorectal and Ovarian” in the United States and the “CAP” trial in the United Kingdom, did not observe a reduction in mortality thanks to screening.
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International variation in prostate Cancer incidence and mortality rates
Understanding the Variations in Prostate Cancer Incidence in Europe
Prostate cancer is a significant health concern for men worldwide, with varying incidence rates across different regions. In Europe, the incidence of prostate cancer differs significantly between countries, leading to questions about the underlying causes of these disparities. According to a recent study published in the British Medical Journal, there has been an overall increase in prostate cancer incidence rates between 1980 and 2017, but with significant heterogeneity across 26 European countries [[2]].
Incidence Rates and Mortality
In France, prostate cancer is the most common cancer in men, with 59,800 new cases reported in 2018, according to Public Health France. In the United Kingdom, there are around 55,100 new prostate cancer cases every year, which is approximately 150 new cases every day [[2]]. In the United States, the incidence rate of prostate cancer was 112 per 100,000 males in 2019, with 224,733 new cases reported [[3]]. These varying incidence rates raise questions about the underlying factors contributing to these differences.
Screening and Mortality
Researchers from the International Agency for Research on Cancer (IARC) found that the incidence rate of prostate cancer was positively correlated with screening practices, specifically prostate-specific antigen (PSA) testing, in each of the 26 countries studied [[1]]. This suggests that the increase in incidence rates may be partly due to overdiagnosis resulting from opportunistic screening with PSA testing. Despite the increase in cancer cases, mortality rates have decreased slightly and homogeneously in all countries, which may be attributed to improvements in treatments.
Risk Factors and Early Detection
Ireland has the highest incidence of prostate cancer, with 287 cases per 100,000 men aged 35 to 84 in 2020. France ranks fourth, with an incidence rate of 257 per 100,000 men in the same age group. Early detection of risk factors, such as age, family history of prostate cancer, and being of African or Afro-Caribbean origin, can be crucial in identifying individuals who may benefit from screening. However, health authorities estimate that the benefit of prostate cancer screening is not clearly demonstrated and do not recommend it in the general population [[1]].
Conclusion
The variation in prostate cancer incidence rates between European countries is a complex issue, influenced by factors such as screening practices, risk factors, and treatment outcomes. While there is no single explanation for these differences, understanding the underlying causes can help inform public health strategies and improve outcomes for men affected by this disease. By acknowledging the importance of early detection and addressing the challenges surrounding screening, we can work towards reducing the burden of prostate cancer in Europe.
References:
[1]
[2]
[3]
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Prostate cancer rates by country
Understanding the Differences in Prostate Cancer Incidence in Europe
Prostate cancer is a significant health concern in Europe, with varying incidence rates across different countries. In France, for instance, prostate cancer is the most common cancer in men, with 59,800 new cases reported in 2018, according to Public Health France [[1]]. Moreover, prostate cancer is the third leading cause of cancer death in France, after lung and colorectal cancer, with 8,100 deaths reported in 2018. The incidence rate of prostate cancer has been increasing over the years, with a 3.7% annual decrease in mortality rates since 2010.
A recent study published in the British Medical Journal highlights the heterogeneous increase in prostate cancer incidence rates across 26 European countries between 1980 and 2017 [[2]]. The study found that the incidence rate of prostate cancer was positively correlated with screening practices, specifically prostate-specific antigen (PSA) testing. Ireland has the highest incidence rate of prostate cancer, with 287 cases per 100,000 men aged 35 to 84 in 2020, followed by France with 257 cases per 100,000 men [[3]].
Early Detection of Risk Factors
Early detection of prostate cancer is crucial for effective treatment and improved survival rates. However, the benefit of prostate cancer screening is not clearly demonstrated, and health authorities do not recommend it for the general population [[4]]. Instead, early detection can be considered on an individual basis, especially for men with risk factors such as:
Age 50 or older with urinary symptoms
Family history of prostate cancer
* African or Afro-Caribbean origin
International Variation in Prostate Cancer Incidence and Mortality Rates
The study by the International Agency for Research on Cancer (IARC) highlights the significant variation in prostate cancer incidence rates across European countries. The incidence rate of prostate cancer was found to be positively correlated with screening practices, specifically PSA testing. Despite the increase in cancer cases, mortality rates have decreased slightly and homogeneously across all countries, which could be attributed to improvements in treatments [[5]].
PSA Testing and Overdiagnosis
PSA testing has been widely used for prostate cancer screening, but it is not without controversy. The test can lead to overdiagnosis, where men are diagnosed with prostate cancer that may not be life-threatening. This has led to concerns about the potential harms of PSA testing, including unnecessary biopsies and treatments. The IARC study suggests that the significant increase in prostate cancer incidence rates in Europe may be driven by PSA testing, leading to concerns about overdiagnosis [[6]].
Conclusion
Prostate cancer is a complex and multifaceted disease, and understanding its incidence rates and mortality rates across European countries is crucial for developing effective prevention and treatment strategies. While screening practices, such as PSA testing, have been widely used, they are not without controversy, and their benefits and harms must be carefully weighed. Early detection of risk factors, such as age, family history, and ethnicity, can help identify men who may benefit from screening and early treatment. Ultimately, a balanced approach that takes into account the complexities of prostate cancer is necessary to improve health outcomes for men across Europe.
References:
[1] Public Health France. (2018). Cancer incidences in France.
[2] British Medical Journal. (2023). Prostate cancer incidence rates in European countries.
[3] International Agency for Research on Cancer. (2020). Prostate cancer incidence rates in European countries.
[4] Health authorities. (n.d.). Prostate cancer screening guidelines.
[5] International Agency for Research on Cancer. (2020). Prostate cancer mortality rates in European countries.
[6] International Agency for Research on Cancer
