Objective To provide a baseline comparative assessment of the main epidemiological features of prostate cancer in European populations as background for the proposed EU screening initiatives. Design Population based study. Setting 26 European countries, 19 in the EU, 1980-2017. National or subnational incidence data were extracted from population based cancer registries from the International Agency for Research on Cancer’s Global Cancer Observatory, and mortality data from the World Health Organization. Population Men aged 35-84 years from 26 eligible countries. Results Over the past decades, incidence rates for prostate cancer varied markedly in both magnitude and rate of change, in parallel with temporal variations in prostate specific antigen testing. The variation in incidence across countries was largest around the mid-2000s, with rates spanning from 46 (Ukraine) to 336 (France) per 100 000 men. Thereafter, incidence started to decline in several countries, but with the latest rates nevertheless remaining raised and increasing again in the most recent quinquennium in several countries. Mortality rates during 1980-2020 were much lower and less variable than incidence rates, with steady declines in most countries and lesser temporal differences between countries. Overall, the up to 20-fold variation in prostate cancer incidence contrasts with a corresponding fivefold variation in mortality. Also, the inverse U-shape of the age specific curves for incidence contrasted with the mortality pattern, which increased progressively with age. The difference between the highest and lowest incidence rates across countries ranged from 89.6 per 100 000 men in 1985 to 385.8 per 100 000 men in 2007, while mortality rates across countries ranged from 23.7 per 100 000 men in 1983 to 35.6 per 100 000 men in 2006. Conclusions The epidemiological features of prostate cancer presented here are indicative of overdiagnosis varying over time and across populations. Although the results are ecological in nature and must be interpreted with caution, they do support previous recommendations that any future implementation of prostate cancer screening must be carefully designed with an emphasis on minimising the harms of overdiagnosis. All data used for analyses are available from the International Agency for Research on Cancer at and the World Health Organization at .

中文翻译：

---

欧洲前列腺癌的发病率和死亡率以及对筛查活动的影响：基于人群的研究


目的 为欧洲人群中前列腺癌的主要流行病学特征提供基线比较评估，作为拟议的欧盟筛查举措的背景。设计基于人群的研究。设置 26 个欧洲国家，其中 19 个位于欧盟，1980-2017 年。国家或国家以下各级的发病率数据是从国际癌症研究机构全球癌症观测站的基于人群的癌症登记处提取的，死亡率数据是从世界卫生组织提取的。人口 来自 26 个符合条件的国家，年龄在 35-84 岁之间的男性。结果在过去的几十年里，前列腺癌的发病率在幅度和变化率上都存在显着差异，与前列腺特异性抗原检测的时间变化一致。各国之间的发病率差异在 2000 年代中期左右最大，发病率从每 10 万名男性 46 例（乌克兰）到 336 例（法国）不等。此后，一些国家的发病率开始下降，但最新的发病率仍然上升，并且在最近五年中一些国家再次上升。 1980年至2020年期间，死亡率远低于发病率，且变化较小，大多数国家稳步下降，国家之间的时间差异也较小。总体而言，前列腺癌发病率高达 20 倍的变化与相应的死亡率的五倍变化形成鲜明对比。此外，发病率的年龄特定曲线的倒 U 形与死亡率模式形成鲜明对比，死亡率随着年龄的增长而逐渐增加。各国最高和最低发病率之间的差异为 1985 年每 10 万名男性 89.6 例到 2007 年每 10 万名男性 385.8 例，而各国死亡率为 23 例。1983 年每 100 000 名男性 7 例增加到 2006 年每 100 000 名男性 35.6 例。 结论 本文介绍的前列腺癌的流行病学特征表明过度诊断随时间和人群的不同而变化。尽管结果本质上是生态性的并且必须谨慎解释，但它们确实支持之前的建议，即未来任何前列腺癌筛查的实施都必须仔细设计，重点是尽量减少过度诊断的危害。用于分析的所有数据均可从国际癌症研究机构 (网址) 和世界卫生组织 (网址) 获取。