Influence of the diagnostic protocol and age on the prostate cancer incidence rate in Castilla y León according to the national registry 2010

Actas Urol Esp (Engl Ed). 2021 Jun;45(5):383-390. doi: 10.1016/j.acuroe.2021.04.002. Epub 2021 May 14.
[Article in English, Spanish]

Abstract

Objective: Cross-sectional descriptive observational study of incidence and association, to determine whether the higher incidence of prostate cancer in Castilla y León (with respect to the national rate) could be due to modifiable factors.

Location: University Hospital Río Hortega.

Participants: New prostate cancer diagnoses.

Main measurements: Incidence rate (IR). Age, family history, symptoms, comorbidity, rectal examination, ultrasound volume (cc), PSA (ng/mL), cylinders, volume cylinder ratio, Gleason, TNM and D'Amico groups.

Results: Castilla y León showed the highest prostate cancer IR in Spain (141.1 per 100,000 inhabitants per year), with a peak of early incidence (65-74 years) and significant differences in < 64 and 65-74 years. Age at diagnosis was the lowest (Castilla y León, 66.9 ±7.1 vs. Spain, 69.1 ± 8.2 years; P < .001). No differences: family history, symptoms, comorbidity and PSA. The number of cylinders was 10.7 ± 1.8. In multivariate analysis (AUC = 0.801; P < .001), they were more frequent in Castilla y León: grade i rectal examination, non-palpable rectal examination, Gleason < 6, stage T2c and the volume cylinder ratio < 6 (only in < 64 years: OR 5.2; 95% CI 1.2-22-22.3; P = .027). In Spanish regions, volume cylinder ratio showed inverse correlation with IR in < 74 years, while age showed positive correlation in all age groups.

Conclusions: The higher prostate cancer IR in Castilla y León in 2010 was not associated to an older population. However, the biopsy technique influenced IR, as more cylinders were obtained in younger subjects, without conditioning overdiagnosis.

Keywords: Ageing; Biopsy methods; Cribado; Cáncer de próstata; Envejecimiento; Incidence; Incidencia; Overdiagnosis; Prostatic neoplasms; Screening; Sobrediagnóstico; Técnicas de biopsia.

Publication types

  • Observational Study

MeSH terms

  • Cross-Sectional Studies
  • Humans
  • Incidence
  • Male
  • Observational Studies as Topic
  • Prostatic Neoplasms* / diagnosis
  • Registries
  • Spain / epidemiology