PD26-01 CHANGES IN CLINICO-PATHOLOGICAL CHARACTERISTICS AT PROSTATE CANCER DIAGNOSIS DETECTED ON PROSTATE BIOPSIES IN DANISH MEN FROM 1995 TO 2011

Abstract

You have accessJournal of UrologyProstate Cancer: Detection & Screening VI1 Apr 2016PD26-01 CHANGES IN CLINICO-PATHOLOGICAL CHARACTERISTICS AT PROSTATE CANCER DIAGNOSIS DETECTED ON PROSTATE BIOPSIES IN DANISH MEN FROM 1995 TO 2011 Nina Klemann, John T. Helgstrand, M. Andreas Røder, Klaus Brasso, Birgitte Grønkær Toft, Ben Vainer, and Peter Iversen Nina KlemannNina Klemann More articles by this author , John T. HelgstrandJohn T. Helgstrand More articles by this author , M. Andreas RøderM. Andreas Røder More articles by this author , Klaus BrassoKlaus Brasso More articles by this author , Birgitte Grønkær ToftBirgitte Grønkær Toft More articles by this author , Ben VainerBen Vainer More articles by this author , and Peter IversenPeter Iversen More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.362AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The incidence of prostate cancer (PCa) in Denmark has increased dramatically during the past two decades. PCa now accounts for 25% of all male cancers in Denmark, a change that parallels an increased use of PSA testing among healthy men. We hypothesized that this development has had a tremendous impact on clinico-pathological parameters at diagnosis of PCa over time, due to lead time bias. METHODS We analyzed data from the Danish Prostate Cancer Registry (DaPCaR) created at our institution, which includes all Danish men who have undergone histopathological examination of prostate tissue in the period 1995-2011. We identified all diagnostic biopsies, defined as the first needle core biopsy containing PCa, and described changes in age at diagnosis, biopsy Gleason score (GS) and clinical T-category. RESULTS A total of 37,723 diagnostic biopsy-sets were identified. In 1995, a total of 343 men were diagnosed with PCa on needle core biopsy vs 3958 men in 2011. Median age at diagnosis decreased from 72 years in 2005 to 69 years in 2011 (p<0,0001). The percentage of patients aged 65 years or younger at the time of diagnosis was 21.9% in 1995 compared to 32.9% in 2011. We observed several changes in the distribution of biopsy GS. The most prominent changes in GS were seen from 2005 and onwards, where the total number of patients diagnosed with PCa GS≤6 decreased from 34.8% to 28.2% with a concurrent increment in men with GS=7 from 27.7% to 36.8%(p<0,0001). Biopsy GS≥ 8 increased only very slightly from 33.4% to 33,6% from 2005 to 2011 (p<0,0001). Also, a change in tumor stage at diagnosis was observed with 31.7% classified with localized disease in 1995 compared to 66.8% in 2011 (p<0.0001). CONCLUSIONS The number of patients diagnosed with PCa on needle core biopsies increased more than ten-fold during the investigated time period. Significant changes in all primary diagnostic clinico-pathological characteristics were observed. The number of men with low and intermediate risk features of PCa increased dramatically which can be speculated to be a result of PSA based detection even though PSA screening has not been recommended in Denmark. A lead time on diagnosis is supported by the fact that the median age at diagnosis decreased with 3 years during a 16-year time span. The increment in men diagnosed with GS=7 from 2005 is suspected to be a consequence of revised international consensus guidelines and is unlikely to reflect changes in tumor biology. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e644 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Nina Klemann More articles by this author John T. Helgstrand More articles by this author M. Andreas Røder More articles by this author Klaus Brasso More articles by this author Birgitte Grønkær Toft More articles by this author Ben Vainer More articles by this author Peter Iversen More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...