NDLI: Impact of PSA testing and prostatic biopsy on cancer incidence and mortality: comparative study between the Republic of Ireland and Northern Ireland

Content Provider	Springer Nature Link
Author	Carsin, A E. Drummond, F. J. Black, A. Leeuwen, P. J. Sharp, L. Murray, L. J. Conlly, D. Egevad, L. Boniol, M. Autier, P. Comber, H. Gavin, A.
Copyright Year	2010
Abstract	To investigate the impact of different PSA testing policies and health-care systems on prostate cancer incidence and mortality in two countries with similar populations, the Republic of Ireland (RoI) and Northern Ireland (NI).Population-level data on PSA tests, prostate biopsies and prostate cancer cases 1993–2005 and prostate cancer deaths 1979–2006 were compiled. Annual percentage change (APC) was estimated by joinpoint regression.Prostate cancer rates were similar in both areas in 1994 but increased rapidly in RoI compared to NI. The PSA testing rate increased sharply in RoI (APC = +23.3%), and to a lesser degree in NI (APC = +9.7%) to reach 412 and 177 tests per 1,000 men in 2004, respectively. Prostatic biopsy rates rose in both countries, but were twofold higher in RoI. Cancer incidence rates rose significantly, mirroring biopsy trends, in both countries reaching 440 per 100,000 men in RoI in 2004 compared to 294 in NI. Median age at diagnosis was lower in RoI (71 years) compared to NI (73 years) (p < 0.01) and decreased significantly over time in both countries. Mortality rates declined from 1995 in both countries (APC = −1.5% in RoI, −1.3% in NI) at a time when PSA testing was not widespread.Prostatic biopsy rates, rather than PSA testing per se, were the main driver of prostate cancer incidence. Because mortality decreases started before screening became widespread in RoI, and mortality remained low in NI, PSA testing is unlikely to be the explanation for declining mortality.
Starting Page	1523
Ending Page	1531
Page Count	9
File Format	PDF
ISSN	09575243
Journal	Cancer Causes & Control
Volume Number	21
Issue Number	9
e-ISSN	15737225
Language	English
Publisher	Springer Netherlands
Publisher Date	2010-06-01
Publisher Place	Dordrecht
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Prostate cancer Trends PSA tests Incidence Mortality Hematology Epidemiology Public Health/Gesundheitswesen Oncology Biomedicine general Cancer Research
Content Type	Text
Resource Type	Article
Subject	Cancer Research Oncology

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