Influence of the diagnostic protocol and age on the prostate cancer incidence rate in Castilla y León according to the national registry 2010

Abstract

ObjectiveCross-sectional descriptive observational study of incidence and association, to determine whether the higher incidence of prostate cancer in Castilla y León (with respect to the national rate) could be due to modifiable factors. LocationUniversity Hospital Río Hortega. ParticipantsNew prostate cancer diagnoses. Main measurementsIncidence rate (IR). Age, family history, symptoms, comorbidity, rectal examination, ultrasound volume (cc), PSA (ng/mL), cylinders, volume cylinder ratio, Gleason, TNM and D’Amico groups. ResultsCastilla y León showed the highest prostate cancer IR in Spain (141.1 per 100,000 inhabitants per year), with a peak of early incidence (65−74 years) and significant differences in < 64 and 65−74 years. Age at diagnosis was the lowest (Castilla y León, 66.9 ±7.1 vs. Spain, 69.1 ± 8.2 years; P < .001). No differences: family history, symptoms, comorbidity and PSA. The number of cylinders was 10.7 ± 1.8. In multivariate analysis (AUC = 0.801; P < .001), they were more frequent in Castilla y León: grade i rectal examination, non-palpable rectal examination, Gleason < 6, stage T2c and the volume cylinder ratio < 6 (only in < 64 years: OR 5.2; 95% CI 1.2-22−22.3; P = .027). In Spanish regions, volume cylinder ratio showed inverse correlation with IR in < 74 years, while age showed positive correlation in all age groups. ConclusionsThe higher prostate cancer IR in Castilla y León in 2010 was not associated to an older population. However, the biopsy technique influenced IR, as more cylinders were obtained in younger subjects, without conditioning overdiagnosis.