BACKGROUND: The incidence of prostate cancer (PC) increased vastly as a result of prostate-specific antigen (PSA) testing. Survival in PC improved in the PSA-testing era, but changes in clinical presentation have hampered the interpretation of the underlying causes. DESIGN: We analyzed survival trends in PC using data from the NORDCAN database for Denmark (DK), Finland (FI), Norway (NO) and Sweden (SE) by analyzing 1-, 5- and 10-year relative survival and conditional relative survival over the course of 50 years (1971-2020). RESULTS: In the pre-PSA era, survival improved in FI and SE and improved marginally in NO but not in DK. PSA testing began toward the end of the 1980s; 5-year survival increased by approximately 30%, and 10-year survival improved even more. Conditional survival from years 6 to 10 (5 years) was better than conditional survival from years 2 to 5 (4 years), but by 2010, this difference disappeared in countries other than DK. Survival in the first year after diagnosis approached 100%; by year 5, it was 95%; and by year 10, it was 90% in the best countries, NO and SE. CONCLUSIONS: In spite of advances in diagnostics and treatment, further attention is required to improve PC survival.

Biomedical Center Faculty of Medicine Charles University Pilsen 30605 Pilsen Czech Republic

Cancer Gene Therapy Group Translational Immunology Research Program University of Helsinki 00290 Helsinki Finland

Comprehensive Cancer Center Helsinki University Hospital 00029 Helsinki Finland

Department of Urology Helsinki University Hospital 00029 Helsinki Finland

Division of Cancer Epidemiology German Cancer Research Center Im Neuenheimer Feld 580 69120 Heidelberg Germany

Division of Pediatric Neurooncology German Cancer Research Center 69120 Heidelberg Germany

Hopp Children's Cancer Center 69120 Heidelberg Germany

Zobrazit více v PubMed

Brasso K., Ingimarsdóttir I.J., Rusch E., Engholm G., Adolfsson J., Tryggvadóttir L., Jónsson E., Bill-Axelson A., Holmberg E., Storm H.H. Differences in survival from prostate cancer in Denmark, Iceland and Sweden. Eur. J. Cancer. 2013;49:1984–1992. doi: 10.1016/j.ejca.2013.01.008. PubMed DOI

Møller M.H., Kristiansen I.S., Beisland C., Rørvik J., Støvring H. Trends in stage-specific incidence of prostate cancer in Norway, 1980–2010: A population-based study. BJU Int. 2016;118:547–555. doi: 10.1111/bju.13364. PubMed DOI

Kavasmaa O.T., Tyomkin D.B., Mehik A., Parpala T.M., Tonttila P., Paananen I., Kunelius P., Vaarala M.H., Ohtonen P., Hellström P.A. Changing trends in symptomatology, diagnostics, stage and survival of prostate cancer in Northern Finland during a period of 20 years. World J. Surg. Oncol. 2013;11:258. doi: 10.1186/1477-7819-11-258. PubMed DOI PMC

Walter S.D., Hu J., Talala K., Tammela T., Taari K., Auvinen A. Estimating the rate of overdiagnosis with prostate cancer screening: Evidence from the Finnish component of the European Randomized Study of Screening for Prostate Cancer. Cancer Causes Control. 2021;32:1299–1313. doi: 10.1007/s10552-021-01480-8. PubMed DOI

Vickers A.J., Sjoberg D.D., Ulmert D., Vertosick E., Roobol M.J., Thompson I., Heijnsdijk E.A., De Koning H., Atoria-Swartz C., Scardino P.T., et al. Empirical estimates of prostate cancer overdiagnosis by age and prostate-specific antigen. BMC Med. 2014;12:26. doi: 10.1186/1741-7015-12-26. PubMed DOI PMC

Enikeev D., Misrai V., Rijo E., Sukhanov R., Chinenov D., Gazimiev M., Taratkin M., Azilgareeva C., Morozov A., Herrmann T.R.W., et al. EAU, AUA and NICE Guidelines on Surgical and Minimally Invasive Treatment of Benign Prostate Hyperplasia: A Critical Appraisal of the Guidelines Using the AGREE-II Tool. Urol. Int. 2022;106:1–10. doi: 10.1159/000517675. PubMed DOI

Liu J., Li Y., Yang D., Yang C., Mao L. Current state of biomarkers for the diagnosis and assessment of treatment efficacy of prostate cancer. Discov. Med. 2019;27:235–243. PubMed

Parker C., Castro E., Fizazi K., Heidenreich A., Ost P., Procopio G., Tombal B., Gillessen S. Prostate cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann. Oncol. 2020;31:1119–1134. doi: 10.1016/j.annonc.2020.06.011. PubMed DOI

Westerberg M., Franck Lissbrant I., Damber J.E., Robinson D., Garmo H., Stattin P. Temporal changes in survival in men with de novo metastatic prostate cancer: Nationwide population-based study. Acta Oncol. 2020;59:106–111. doi: 10.1080/0284186X.2019.1662084. PubMed DOI

Storås A.H., Fosså S.D., Ursin G., Andreassen B.K. Survival trends for patients with primary metastatic prostate cancer before and after the introduction of new antitumor drugs. Prostate Cancer Prostatic Dis. 2023;26:53–58. doi: 10.1038/s41391-021-00445-x. PubMed DOI

Devasia T.P., Mariotto A.B., Nyame Y.A., Etzioni R. Estimating the Number of Men Living with Metastatic Prostate Cancer in the United States. Cancer Epidemiol. Biomarkers Prev. 2023;32:659–665. doi: 10.1158/1055-9965.EPI-22-1038. PubMed DOI PMC

Borno H.T., Cowan J.E., Zhao S., Broering J.M., Carroll P.R., Ryan C.J. Examining initial treatment and survival among men with metastatic prostate cancer: An analysis from the CaPSURE registry. Urol. Oncol. 2020;38:e791–e793. doi: 10.1016/j.urolonc.2020.07.012. PubMed DOI

Riihimaki M., Thomsen H., Brandt A., Sundquist J., Hemminki K. What do prostate cancer patients die of? Oncologist. 2011;16:175–181. doi: 10.1634/theoncologist.2010-0338. PubMed DOI PMC

Wong K.F., Lambert P.C., Mozumder S.I., Broggio J., Rutherford M.J. Conditional crude probabilities of death for English cancer patients. Br. J. Cancer. 2019;121:883–889. doi: 10.1038/s41416-019-0597-0. PubMed DOI PMC

Riihimäki M., Thomsen H., Sundquist K., Sundquist J., Hemminki K. Clinical landscape of cancer metastases. Cancer Med. 2018;7:5534–5542. doi: 10.1002/cam4.1697. PubMed DOI PMC

Helgstrand J.T., Røder M.A., Klemann N., Toft B.G., Brasso K., Vainer B., Iversen P. Diagnostic characteristics of lethal prostate cancer. Eur. J. Cancer. 2017;84:18–26. doi: 10.1016/j.ejca.2017.07.007. PubMed DOI

Orrason A.W., Westerberg M., Garmo H., Lissbrant I.F., Robinson D., Stattin P. Changes in treatment and mortality in men with locally advanced prostate cancer between 2000 and 2016: A nationwide, population-based study in Sweden. BJU Int. 2020;126:142–151. doi: 10.1111/bju.15077. PubMed DOI

Hemminki J., Försti A., Hemminki A., Hemminki K. Survival trends in solid cancers in the Nordic countries through 50 years. Eur. J. Cancer. 2022;175:77–85. doi: 10.1016/j.ejca.2022.08.015. PubMed DOI

Janssen-Heijnen M.L., Gondos A., Bray F., Hakulinen T., Brewster D.H., Brenner H., Coebergh J.W. Clinical relevance of conditional survival of cancer patients in europe: Age-specific analyses of 13 cancers. J. Clin. Oncol. 2010;28:2520–2528. doi: 10.1200/JCO.2009.25.9697. PubMed DOI

Rosiello G., Palumbo C., Knipper S., Pecoraro A., Luzzago S., Deuker M., Mistretta F.A., Tian Z., Fossati N., Gallina A., et al. Contemporary conditional cancer-specific survival after radical nephroureterectomy in patients with nonmetastatic urothelial carcinoma of upper urinary tract. J. Surg. Oncol. 2020;121:1154–1161. doi: 10.1002/jso.25877. PubMed DOI

Tappero S., Cano Garcia C., Incesu R.B., Piccinelli M.L., Barletta F., Morra S., Scheipner L., Tian Z., Saad F., Shariat S.F., et al. Conditional survival for non-metastatic muscle-invasive adenocarcinoma of the urinary bladder after radical cystectomy. Surg. Oncol. 2023;48:101947. doi: 10.1016/j.suronc.2023.101947. PubMed DOI

Pukkala E., Engholm G., Hojsgaard Schmidt L.K., Storm H., Khan S., Lambe M., Pettersson D., Olafsdottir E., Tryggvadottir L., Hakanen T., et al. Nordic Cancer Registries—An overview of their procedures and data comparability. Acta Oncol. 2018;57:440–455. doi: 10.1080/0284186X.2017.1407039. PubMed DOI

Engholm G., Ferlay J., Christensen N., Bray F., Gjerstorff M.L., Klint A., Køtlum J.E., Olafsdóttir E., Pukkala E., Storm H.H. NORDCAN—A Nordic tool for cancer information, planning, quality control and research. Acta Oncol. 2010;49:725–736. doi: 10.3109/02841861003782017. PubMed DOI

Larønningen S., Ferlay J., Beydogan H., Bray F., Engholm G., Ervik M., Gulbrandsen J., Hansen H., Hansen H., Johannesen T., et al. NORDCAN: Cancer Incidence, Mortality, Prevalence and Survival in the Nordic Countries. Cancer Registry of Norway; Oslo, Norway: 2022. Version 9.2. Association of the Nordic Cancer Registries.

Storm H.H., Klint A., Tryggvadóttir L., Gislum M., Engholm G., Bray F., Hakulinen T. Trends in the survival of patients diagnosed with malignant neoplasms of lymphoid, haematopoietic, and related tissue in the Nordic countries 1964–2003 followed up to the end of 2006. Acta Oncol. 2010;49:694–712. doi: 10.3109/02841861003631495. PubMed DOI

Engholm G., Gislum M., Bray F., Hakulinen T. Trends in the survival of patients diagnosed with cancer in the Nordic countries 1964–2003 followed up to the end of 2006. Material and methods. Acta Oncol. 2010;49:545–560. doi: 10.3109/02841861003739322. PubMed DOI

Lundberg F.E., Andersson T.M., Lambe M., Engholm G., Mørch L.S., Johannesen T.B., Virtanen A., Pettersson D., Ólafsdóttir E.J., Birgisson H., et al. Trends in cancer survival in the Nordic countries 1990–2016: The NORDCAN survival studies. Acta Oncol. 2020;59:1266–1274. doi: 10.1080/0284186X.2020.1822544. PubMed DOI

Tichanek F., Försti A., Liska V., Hemminki A., Hemminki K. Survival in Colon, Rectal and Small Intestinal Cancers in the Nordic Countries through a Half Century. Cancers. 2023;15:991. doi: 10.3390/cancers15030991. PubMed DOI PMC

Kvåle R., Auvinen A., Adami H.O., Klint A., Hernes E., Møller B., Pukkala E., Storm H.H., Tryggvadottir L., Tretli S., et al. Interpreting trends in prostate cancer incidence and mortality in the five Nordic countries. J. Natl. Cancer Inst. 2007;99:1881–1887. doi: 10.1093/jnci/djm249. PubMed DOI

Seikkula H., Kaipia A., Boström P.J., Malila N., Pitkäniemi J., Seppä K. Periodic trends in geographical variation of prostate cancer incidence and mortality in Finland between 1985 and 2019. Acta Oncol. 2022;61:1209–1215. doi: 10.1080/0284186X.2022.2112971. PubMed DOI

Allemani C., Matsuda T., Di Carlo V., Harewood R., Matz M., Nikšić M., Bonaventure A., Valkov M., Johnson C.J., Estève J., et al. Global surveillance of trends in cancer survival 2000–14 (CONCORD-3): Analysis of individual records for 37 513 025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries. Lancet. 2018;391:1023–1075. doi: 10.1016/S0140-6736(17)33326-3. PubMed DOI PMC

Taitt H.E. Global Trends and Prostate Cancer: A Review of Incidence, Detection, and Mortality as Influenced by Race, Ethnicity, and Geographic Location. Am. J. Mens Health. 2018;12:1807–1823. doi: 10.1177/1557988318798279. PubMed DOI PMC

Park J., Han K., Shin D.W., Park S.H., Shin H.B. Conditional Relative Survival and Competing Mortality of Patients with Prostate Cancer in Korea: A Nationwide Cohort Study. Cancer Epidemiol. Biomarkers Prev. 2021;30:326–334. doi: 10.1158/1055-9965.EPI-20-1084. PubMed DOI

Luyendijk M., Visser O., Blommestein H.M., de Hingh I., Hoebers F.J.P., Jager A., Sonke G.S., de Vries E.G.E., Uyl-de Groot C.A., Siesling S. Changes in survival in de novo metastatic cancer in an era of new medicines. J. Natl. Cancer Inst. 2023;115:628–635. doi: 10.1093/jnci/djad020. PubMed DOI PMC

Francini E., Gray K.P., Xie W., Shaw G.K., Valença L., Bernard B., Albiges L., Harshman L.C., Kantoff P.W., Taplin M.E., et al. Time of metastatic disease presentation and volume of disease are prognostic for metastatic hormone sensitive prostate cancer (mHSPC) Prostate. 2018;78:889–895. doi: 10.1002/pros.23645. PubMed DOI PMC

Mottet N., van den Bergh R.C.N., Briers E., Van den Broeck T., Cumberbatch M.G., De Santis M., Fanti S., Fossati N., Gandaglia G., Gillessen S., et al. EAU-EANM-ESTRO-ESUR-SIOG Guidelines on Prostate Cancer-2020 Update. Part 1: Screening, Diagnosis, and Local Treatment with Curative Intent. Eur. Urol. 2021;79:243–262. doi: 10.1016/j.eururo.2020.09.042. PubMed DOI

Holmberg L., Bill-Axelson A., Steineck G., Garmo H., Palmgren J., Johansson E., Adami H.O., Johansson J.E. Results from the Scandinavian Prostate Cancer Group Trial Number 4: A randomized controlled trial of radical prostatectomy versus watchful waiting. J. Natl. Cancer Institute. Monogr. 2012;2012:230–233. doi: 10.1093/jncimonographs/lgs025. PubMed DOI PMC

Loeb S., Vellekoop A., Ahmed H.U., Catto J., Emberton M., Nam R., Rosario D.J., Scattoni V., Lotan Y. Systematic review of complications of prostate biopsy. Eur. Urol. 2013;64:876–892. doi: 10.1016/j.eururo.2013.05.049. PubMed DOI

Lundberg F.E., Birgisson H., Johannesen T.B., Engholm G., Virtanen A., Pettersson D., Ólafsdóttir E.J., Lambe M., Lambert P.C., Mørch L.S., et al. Survival trends in patients diagnosed with colon and rectal cancer in the nordic countries 1990–2016: The NORDCAN survival studies. Eur. J. Cancer. 2022;172:76–84. doi: 10.1016/j.ejca.2022.05.032. PubMed DOI

Survival in Thyroid Cancer in Sweden From 1999 To 2018

Critical survival periods in prostate cancer in Sweden explored by conditional survival analysis