Changing Incidence and Stage Distribution of Prostate Cancer in a Lithuanian Population-Evidence from National PSA-Based Screening Program

Int J Environ Res Public Health. 2019 Dec 3;16(23):4856. doi: 10.3390/ijerph16234856.

Abstract

Background: The aim of this study was to examine the impact of screening introduction on prostate cancer incidence changes, and changes in stage distribution in Lithuania between 1998-2016.

Methods: Age-standardized incidence as well as stage-specific incidence rates were calculated. Joinpoint regression was used to estimate the annual percentage change in the incidence changes by determined stage: Localized, advanced, distant and unknown.

Results: Over the study period, a total number of 48,815 new prostate cancer cases was identified. Age-standardized incidence rose from 51.9 per 100,000 in 1998 to 279.3 per 100,000 in 2007 (by 20.3% per year) and then decreased thereafter by 3.8% annually. Highest incidence rates after introduction of prostate specific antigene (PSA)-based screening was found for localized disease, followed by advanced. Incidence of localized disease rose by 38.2% per year until 2007 reaching the highest rate of 284.6 per 100,000, with a subsequent decrease of 5.5% every year thereafter. Advanced stage of disease experienced rise till 2007, and continuous decrease by 11.1% every year thereafter. Incidence of disease with distant metastasis was lowest, and rose till 2003, thereafter incidence significantly decreased by 8.1% every year.

Conclusions: To our knowledge, this is the first report of stage migration effect in Lithuania, following the introduction of nationwide PSA-based screening. Prostate cancer screening substantially increased the overall incidence and incidence of localized cancer.

Keywords: PSA-based screening; incidence; prostate cancer; stage migration.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Early Detection of Cancer
  • Humans
  • Incidence
  • Lithuania / epidemiology
  • Male
  • Middle Aged
  • National Health Programs
  • Neoplasm Staging
  • Prostate-Specific Antigen / analysis*
  • Prostatic Neoplasms / diagnosis*
  • Prostatic Neoplasms / epidemiology*

Substances

  • Prostate-Specific Antigen