How can we explain such differences in the incidence of prostate cancer in Europe? In France, this tumor is The most common cancer in men (59,800 new cases in 2018, according to the French Public Health Service) and the third cause of cancer-related mortality, after lung and colorectal cancer. In 2018, prostate cancer was the cause of 8,100 deaths, a figure that has decreased by 3.7% annually since 2010.
A study published on Wednesday, September 4, in the British Medical Journal It generally shows an increase in the incidence rates of these tumors between 1980 and 2017, but in a quite heterogeneous way depending on the 26 countries studied.
Researchers at the International Agency for Research on Cancer (IARC), an agency of the World Health Organization, working with Chinese and European colleagues, compared incidence rates with screening and mortality rates. In each country, the incidence rate was positively correlated with screening practices: prostate-specific antigen (PSA) testing.
Early detection of risk factors.
Ireland is the country with the highest incidence of prostate cancer: 287 per 100,000 men aged 35 to 84 in 2020. France ranks fourth (257). “The results of this study are consistent with a significant overdiagnosis of prostate cancer resulting from opportunistic screening with the PSA test.”sums up Salvatore Vaccarella, an epidemiologist at IARC who led the study.
However, despite the increase in cancer cases, mortality remains low and has decreased slightly and uniformly in all countries. “The variation in prostate cancer incidence rates between countries during the study period is much greater than that of mortality rates”says Salvatore Vaccarella. According to him, “The decline in mortality is mainly explained by a progressive improvement in treatments.”
The debate surrounding the detection of this cancer is not new. “The benefit of prostate cancer screening is not clearly demonstrated”Health authorities estimate that it is not recommended for the general population. Early detection can be considered on an individual basis, for example in men with risk factors, such as being 50 years of age or older with urinary symptoms, having a family history of prostate cancer or being of African or Afro-Caribbean origin.
Studies (randomised clinical trials) in this field are contradictory: one European trial showed a reduction in the number of deaths after approximately ten years, while other randomised trials, such as the “Prostate, Lung, Colorectal and Ovarian” trial in the United States and the “CAP” trial in the United Kingdom, did not observe a reduction in mortality thanks to screening.
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