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

1
Laboratory of Cancer Epidemiology, National Cancer Institute, LT-08406 Vilnius, Lithuania
2
Institute of Health Sciences, Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuania
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2019, 16(23), 4856; https://doi.org/10.3390/ijerph16234856
Received: 12 November 2019 / Revised: 28 November 2019 / Accepted: 29 November 2019 / Published: 3 December 2019
(This article belongs to the Section Public Health Statistics and Risk Assessment)
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. View Full-Text
Keywords: incidence; prostate cancer; PSA-based screening; stage migration incidence; prostate cancer; PSA-based screening; stage migration
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Patasius, A.; Smailyte, G. 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, 16, 4856.

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