rak stercza dane epidemiologiczne

Nowoczesna diagnostyka raka
prostaty.
Biopsja fuzyjna vs. standardowa
biopsja
VI Podkarpackie Warsztaty
Endoskopowe
25.11.2016r. Krosno
RAK STERCZA
DANE EPIDEMIOLOGICZNE
Lek. Wojciech Tomkalski
Wojewódzki Szpital Podkarpacki
im. Jana Pawła II w Krośnie
Oddział Urologii i Urologii Onkologicznej
Kierownik Oddziału: Dr n. med. Dariusz Sobieraj
Among men alive today, it is estimated that 1
in 7 (15.3%) will be diagnosed with prostate
cancer and 1 in 38 (2.6%) will die from this
Disease
Brawley et al, 2012a
Świat
Świat - zachorowalność
The incidence rate rose by approximately 2% per
year from 1975 to the late 1980s, related in part
to the incidental detectionof prostate cancer
associated with the use of transurethral
resectionof the prostate for benign prostatic
hyperplasia
Potosky AL, Kessler L, Gridley G, et al. Rise in prostatic cancer incidence
associated with increased use of transurethral resection. J Natl Cancer Inst
1990;82:1624–8.
The incidence of prostate cancer rose
dramatically from 1989 to 1992 after the
introduction of a prostate-specific antigen (PSA)
screening test
Siegel R, Ma J, Zou Z, et al. Cancer statistics, 2014. CA Cancer J Clin 2014;
64:9–29.
Świat – wiek postawienia diagnozy
•
Prostate cancer is rarely diagnosed in men less than 50 years of age, accounting
for only 2% of all cases.
Jani AB, Johnstone PA, Liauw SL, et al. Age and grade trends in prostatecancer (1974-2003): a Surveillance, Epidemiology, and End Results Registry analysis.
Am J Clin Oncol 2008;31:375–8.
•
Prior to the PSA era, median age at diagnosis was 70 years, falling to 67 years
over the past decade, with 63% diagnosed after age 65
Ries LAG, Melbert D, Krapcho M, et al, editors. SEER Cancer Statistics Review, 1975-2005. Bethesda (MD): National Cancer Institute; 2008.
Świat – stopień zaawansowania w
momencie diagnozy
•
Since the introduction of PSA testing, 81% of newly diagnosed men have
localized disease, whereas the incidence of metastatic disease has decreased by
75%
Newcomer LM, Stanford JL, Blumenstein BA, et al. Temporal trends in rates of prostate cancer: declining incidence of advanced stage disease, 1974
to 1994. J Urol 1997;158:1427–30.
•
Nonpalpable cancers (AJCC clinical stage T1c) now account for 60% to 75% of
newly diagnosed disease
Gallina A, Chun FK, Suardi N, et al. Comparison of stage migration patterns between Europe and the USA: an analysis of 11 350 men treated with radical
prostatectomy for prostate cancer. BJU Int 2008;101:1513–8.
Świat - umieralność
The observed decline in mortality since 1991 may be due to:
•
(1) early detection and stage migration from PSA screening,
•
(2) increased utilization and effectiveness of curative treatments,
•
(3) changes in the attribution of cause of death, (4) improvementsin therapy for advanced disease, or (
•
(5) increased risk ofdeath from secondary causes among men receiving prostatecancer therapy
Brawley et al, 2012b
•
(6)The result of the more aggressive treatmentof prostate cancer that began in the 1980s
Walsh PC. Cancer surveillance series: interpreting trends in prostate cancer— part I: evidence of the effects of screening in recent prostate cancer incidence,mortality, and survival rates. J
Urol 2000;163:364–5.
•
(7)the vast majority of men diagnosed with prostate cancersince 1986 have received curative-intent therapy at a
rate doublethat observed before 1986
Etzioni R, Tsodikov A, Mariotto A, et al. Quantifying the role of PSA screening
n the US prostate cancer mortality decline. Cancer Causes Control 2008;19:175–81.
Różnice rasowe
•Differences in treatment patterns by race have consistently shown that African-Americans
at every stage get less aggressive therapy regardless of age, marital status, tumor risk, and
Comorbidities status compared to Caucasians, even within equal-access health care systems
Klabunde et al, 1998; Hoffman et al, 2003; Shavers et al, 2004; Gross et al, 2008; Nambudiri et al, 2012; Presley et al, 2013
•Even among those treated with “watchful waiting,” African-Americans receive less
intensive follow-up
Shavers VL, Brown ML, Potosky AL, et al. Race/ethnicity and the receipt of watchful waiting for the initial management of prostate cancer. J Gen Intern Med 2004;19:146–55.
•Japanese immigrants have an incidence more comparable to men of similar ancestry born
in the United States than to those living in Japan
Shimizu H, Ross RK, Bernstein L, et al. Cancers of the prostate and breastamong Japanese and white immigrants in Los Angeles county. Br J Cancer 1991;63:963–6.
Różnice geograficzne
•Age-standardized incidence rates per 100,000 men are highest in the highest income
regions of the world, including North America (85.6), the Caribbean (71.1), Australia and
NewZealand (104.2), Western Europe (93.1), and Scandinavia (73.1),and lowest in Asia (7.2)
and Northern Africa (8.1).
•In 32 of40 countries analyzed, increasing incidence rates over the last one
to two decades were observed, and they had stabilized in 8 countries,
including the United States, Canada, and Australia, where
there was early adoption of PSA screening.
Hsing AW, Tsao L, Devesa SS. International trends and patterns of prostate cancer incidence and mortality. Int J Cancer 2000;85:60–7.
Polska
Didkowska Joanna, Wojciechowska Urszula. Zachorowania i zgony na nowotwory złośliwe w Polsce.
Krajowy Rejestr Nowotworów, Centrum Onkologii - Instytut im. Marii Skłodowskiej - Curie.
Polska - zachorowalność
Didkowska Joanna, Wojciechowska Urszula. Zachorowania i zgony na nowotwory złośliwe w Polsce.
Krajowy Rejestr Nowotworów, Centrum Onkologii - Instytut im. Marii Skłodowskiej - Curie.
Polska na tle Europy - Zachorowalność
69,5
32,3
Zachorowalność na nowotwory gruczołu krokowego w Polsce jest niższa o
około 45% niż przeciętna dla krajów Unii Europejskiej - w 2010 roku
współczynnik umieralności wynosił 32,3/105, natomiast średnia dla krajów
Unii Europejskiej (dane z 2009 roku) – 69,5/105 (rys. 6).
Didkowska Joanna, Wojciechowska Urszula. Zachorowania i zgony na nowotwory złośliwe w Polsce.
Krajowy Rejestr Nowotworów, Centrum Onkologii - Instytut im. Marii Skłodowskiej - Curie.
Polska na tle Europy - Umieralność
12,1
Umieralność z powodu nowotworów gruczołu krokowego w Polsce jest nieco
wyższa niż przeciętna dla krajów Unii Europejskiej - w 2010 roku
współczynnik umieralności wynosił 12,4.105, natomiast średnia dla krajów
Unii Europejskiej (dane z 2009 roku) – 12,1/105. (rys. 5).
Didkowska Joanna, Wojciechowska Urszula. Zachorowania i zgony na nowotwory złośliwe w Polsce.
Krajowy Rejestr Nowotworów, Centrum Onkologii - Instytut im. Marii Skłodowskiej - Curie.
Województwo Podkarpackie
Zakład Epidemiologii i Podkarpacki Rejestr Nowotworów . Podkarpackie Centrum Onkologii
GRUCZOŁ KROKOWY C61 (zachorowania i zgony dla
województwa podkarpackiego za lata 2000-2010)
1999-2010 – wskaźnik surowy na 100 000
60.0
50.5
48.9
50.0
41.3
37.9
40.0
45.3
50.5
45.1
45.0
40.9
35.4
33.1
30.0
16.7
17.9
17.3
17.8
20.2
19.0
20.1
20.5
20.3
21.0
19.7
20.0
10.0
zachorowania
0.0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
Zakład Epidemiologii i Podkarpacki Rejestr Nowotworów . Podkarpackie Centrum Onkologii
2010
zgony
Zachorowalność i umieralność na nowotwór gruczołu krokowego w powiatach
woj. Podkarpackiego w latach 1999- 2011
Zakład Epidemiologii i Podkarpacki Rejestr Nowotworów . Podkarpackie Centrum Onkologii
Nowoczesna diagnostyka raka
prostaty.
Biopsja fuzyjna vs. standardowa
biopsja
VI Podkarpackie Warsztaty
Endoskopowe
25.16 2016r. Krosno