Abstract
Introduction
Register-based studies have shown large survival differences among prostate cancer
patients in the Nordic countries. The aim of this study was to determine the background
of such differences in Denmark, Iceland and Sweden.
Material and methods
Patients with prostate cancer were identified through population-based cancer registers
in the three countries. Clinical findings at diagnosis were retrieved from hospital
records. In Sweden, clinical information was gathered from regional population-based
prostate cancer registers. Country-specific incidence and excess mortality rates were
compared, with adjustment for prognostic factors.
Results
The relative survival in the cohorts was comparable to that in previous population-based
studies. Significant differences in excess mortality rates were found across countries,
which diminished or disappeared after adjustment for patient characteristics, i.e.
metastatic status, clinical T stage and prostate-specific antigen level. A difference
in the proportion of patients with metastatic disease was the main explanation of
the differences in survival among countries, while the incidence rates of metastatic
cancer were similar.
Discussion
Register-based studies of the relative survival of prostate cancer patients are influenced
by national differences in clinical presentation at diagnosis. Differences in the
proportion of patients with metastatic spread explained most of the difference in
relative survival among patients in Denmark, Iceland and Sweden. Future country comparisons
of relative survival should include adjustment for differences in patient characteristics,
such as stage, prostate-specific antigen level and screening intensity.
Keywords
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Article info
Publication history
Published online: March 04, 2013
Identification
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© 2013 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
