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

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 ±â€¯8.2 years; P < .001). No differences: family history, symptoms, comorbidity and PSA. The number of cylinders was 10.7 ±â€¯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.

Influencia del protocolo diagnóstico y la edad en la tasa de incidencia de cáncer de próstata en Castilla y León según el registro nacional de 2010 / Influence of the diagnostic protocol and age on the prostate cancer incidence rate in Castilla y León according to the national registry 2010

Objetivo: Estudio observacional descriptivo transversal de incidencia y asociación, para conocer si la mayor incidencia de cáncer de próstata en Castilla y León (respecto a la tasa nacional) pudiera deberse a factores modificables.EmplazamientoHospital Universitario Río Hortega.ParticipantesNuevos diagnósticos de cáncer de próstata.Mediciones principalesTasa de incidencia (TI). Edad, antecedentes familiares, síntomas, comorbilidad, tacto rectal, volumen ecográfico (cc), PSA (ng/ml), cilindros, relación volumen cilindros, Gleason, TNM y grupos D’Amico.ResultadosLa TI en Castilla y León fue la más alta (141,1 por 100.000 habitantes-año), con un pico de incidencia precoz (65-74 años) y diferencias significativas en<64 y 65-74 años. La edad al diagnóstico fue la más baja (66,9±7,1 vs. 69,1±8,2 años; p<0,001). No hubo diferencias en: antecedentes familiares, síntomas, comorbilidad y PSA. El número de cilindros fue 10,7±1,8. En el análisis multivariante (AUC=0,801; p<0,001) fueron más frecuentes: tacto rectal grado i, tacto rectal no palpable, Gleason<6, estadio T2c y la relación volumen cilindros <6 (solo en<64 años: OR 5,2; IC 95% 1,2-22,3; p=0,027). En las CC. AA., la relación volumen cilindros mostró una correlación inversa con la TI en<74 años, mientras que la edad presentó correlación positiva en todos los tramos.ConclusionesLa mayor TI de cáncer de próstata en Castilla y León 2010 no guardó relación con una población más envejecida. Sin embargo, la técnica de biopsia influyó en la TI, al obtenerse más cilindros en los sujetos más jóvenes, sin condicionar sobrediagnóstico. (AU)

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.LocationUniversity Hospital Río Hortega.ParticipantsNew prostate cancer diagnoses.Main measurementsIncidence 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.ResultsCastilla 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 1.2-22.3; 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.ConclusionsThe 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. (AU)