Epidemiological trends in prostate cancer over the last years

To analyze the evolution of prostate cancer (PCa) in our community health area over the last years, in terms of incidence, clinical-epidemiological characteristics, and cancer-specific mortality. Retrospective analysis of the medical records of patients with PCa in our hospital over the 1991-2003 period. We calculated the annual incidence rates for our community health area as well as its trend over the period of study. Changes of several clinical-epidemiological parameters over time were studied. The evolution of PCa mortality was also analyzed. 730 patients with PCa were evaluated. Median age and PSA at diagnosis were 69 years and 11.4 ng/ml, respectively. 60.5% tumors were detected in a localized clinical stage, and 18.6% were metastasic. 30.4% of PCa in the study (the most numerous group) had a Gleason score between 5 and 6. A constant increase of PCa incidence was observed with an annual percentage increase of 5.5% (p < 0.001). Standardized incidence rate for the year 2003 Spanish population pyramid was 100.9 cases/100,000 males. A significant trend to a greater proportion of PCa cases diagnosed by uncontrolled screening was observed, being the cases currently detected after symptoms only a small proportion (p < 0.001). Decreases in the age at diagnosis (p < 0.001), PSA level (p < 0.001), proportion of advanced clinical stages (p < 0.001), as well as proportion of cancers with well-differentiated Gleason score (2-4) (p < 0.001) were also detected. PCa mortality adjusted by the population pyramid was 8.7 deaths/100,000 males in the year 2003. We found an increase in the incidence of prostate cancer in our community health area over the last years, parallel to an increase in the proportion of cases detected by screening in asymptomatic population. Because of that, tumors currently detected tend to appear in younger ages, with lower PSA levels, and localized clinical stages.