engleski

Epidemiology of prostate cancer

The accelerating rates of prostate cancer incidence in the world could be explained partly by aging of the population and partly by introduction of screening programs for early detection of prostate cancer; but simultaneuos increses in mortality rates suggests that other factors are involved. Prostate cancer is the fourth most common form of cancer in male cancer incidence in the world. In 1996, there are around 400 000 new patients with a diagnosis of prostate cancer and, 204 000 prostate cancer deaths . Prostate cancer exibits a large differnces between high and low-risk populations. The most important risk factors for prostate cancer are age, race and family history. A large number of enviromental factors that includes sexual behaviour. Sexually transmitted viruses, occupational exposure, alcohol, smoking, radiation, vasectomy has been investigated, but withouth much succes. The most promising may be the etiologic hypothesis about nutrition. The role of genetic factors is still unresolved, and it is probably related to some asoects of androgen mechanism. According to the Croatian National Cancer registry data (not including skin cancer), prostate cancer is the fourth most common form of cancer in men of Croatia. In 1993., the number of newly diagnosed cases was 610 (rate 26.3/100 000 ), wich is a rise of 81 percent comoperd to 3777 newly diagnosed cases in 1968. The number of prostate cancer deths had raisen from 1997 in 1968 to 441, wich is a raise of 223 percent. Incudence rates incresase with age, beginning after the age of 40, and particulary after age of 60-70. Age adjusted incidence rates (to the world population) are 17.5 /100 000 in Croatia. In the USA (SEER program) , incidnece rates for black population (that has the highest rates in the world ) are 137, and for Caucasians 100.8/100000. In Canada , reported are 64.7 in Sweden 55.3, in Austria 51.6, In Finland 41.3 in UK 28.0 in Slovenia 20.7. The lowest rates are seen in some parts of China 0.5/100 000.There are no real recomendations for prostate cancer prevention. The prevention is carried out by nutritional counseling and early detection. Until the results of large rendomzed control trials are available, the results of screening for prostate cancer remain controversial. Therefore, a major effort is requred to reduce the impact of the continuing increase in absolute numbers of prostae cancer cases on health services.

prostate; carcinoma; incidence; mortality; risk factors

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