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Swedish Study Shows Prostate Cancer |
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July 21, 2004 |
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Natural History of Prostate Cancer: a Late Killer Abstracted from: |
The study is important because previous natural history
studies of CaP were hampered by small numbers, loss of men to various
The key figure is reproduced here. Average age at diagnosis was 72 years. 48% of the tumors were incidental discoveries in prostate tissue removed for obstruction; the remainder had a palpable abnormality. PSA screening was not used; recruitment was between the years 1977 – 1984. In an accompanying editorial, Drs. Neugut and Grann of Columbia University state that the acceleration in CaP mortality after 15 years could be caused by (1) the advent of PSA testing and increased detection of disease, (2) emergence of more aggressive tumors, (3) or perhaps even by cardiovascular diseases associated with estrogen treatment used in this study for CaP progression. With regard to CaP screening, Neugut and Grann state that “…a horizon of 15 to 20 years…(may) be necessary to really observe the impact of PSA screening on prostate cancer.” RELATED LINKS: |
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Orebro,
Sweden (June, 2004) – A major advance in knowledge of prostate
cancer (CaP) natural history was revealed this month with publication
of the largest, longest study of disease progression yet conducted.
In a recent 
treatment
options, and/or insufficient follow-up. In rural Central Sweden, where
this study was set, more than 98% of the eligible men having localized
CaP were included in the study. Average observation period was 21 years,
with 91% of the men followed until death. Not a single man was lost
to follow-up. Mortality from CaP increased from 15/1000 person-years
during the first 15 years of follow-up to 44/1000 beyond 15 years (p<0.01).