Wednesday, October 21, 2015: 11:00 AM
Grand Ballroom C (Hyatt Regency St. Louis at the Arch)

Mette Holm Møller, Bsc Public Health, Aarhus University, Denmark, Aarhus, Denmark, Ivar Sønbø Kristiansen, MD, PhD, MPH, Department of Health Management and Health Economics, University of Oslo, Oslo, Norway, Christian Beisland, Department of Urology, Surgical Clinic, Haukeland University Hospital, Bergen, Norway, Jarle Rørvik, Department of Radiology, Haukeland University Hospital, Bergen, Norway and Henrik Støvring, Department of Public Health, Section for Biostatistics, Aarhus University, Aarhus, Denmark
Purpose: To estimate the changes in the stage distribution of prostate cancer (PC) after the introduction of opportunistic PSA-testing.

Method: From the Cancer Registry of Norway we obtained cancer stage, age and year of diagnosis on all men over the age of 50 diagnosed with PC during the period 1980-2010 in Norway. Three calendar-time periods were defined: One before the introduction of PSA-testing (1980-1989) and two after reflecting increasing diagnostic intensity (1990-2000 and 2001-2010); and three age groups: men eligible for PSA-testing (50-65 and 66-74) or older (75+). Birth-cohorts were categorized into four intervals: <1910, 1916-1925, 1926-1940 and >1941. We used Poisson regression to conduct a cross-sectional and a cohort-based analysis of trends in the incidence of localised, regional and distant cancer, respectively.

Result: The annual incidence of localised PC among men aged 50-65 and 66-74 rose from 41.4 and 255.2 per 100,000 before the introduction of PSA-testing to 137.9 and 418.7 in 2001-2010 afterwards, respectively, corresponding to 3.3 (CI: 3.1; 3.5) and 1.6 (CI: 1.6; 1.7) fold increases. The incidence of regional cancers increased by a factor seven and four among men aged <75 and 75+, respectively. The incidence of distant cancers among men aged 75+ decreased from 218.8 to 155.1 per 100,000, corresponding to a decrease of 0.7 (CI: 0.7; 0.8). The cohort-based analysis showed that the incidence of localised and regional PC shifted downwards to younger men, with a gradually decreased incidence of distant cancer in more recent cohorts.

Conclusion: Opportunistic PSA-testing substantially increased the incidence of localised and regional PC among men aged 50-74 years. The increase was not fully compensated in absolute numbers by the decrease in incidence of distant PC in older men, although it decreased by 30%.