TY - JOUR
T1 - Temporal Trends in Clinical and Pathological Characteristics for Men Undergoing Radical Prostatectomy Between 1995 and 2013 at Rigshospitalet, Copenhagen, Denmark, and Stanford University Hospital, United States
AU - Loft, Mathias Dyrberg
AU - Berg, Kasper Drimer
AU - Kjaer, Andreas
AU - Iversen, Peter
AU - Ferrari, Michelle
AU - Zhang, Chiyuan A.
AU - Brasso, Klaus
AU - Brooks, James D.
AU - Røder, Martin Andreas
PY - 2018/2
Y1 - 2018/2
N2 - Prostate-specific antigen (PSA) screening is not officially recommended for the detection of prostate cancer in Denmark; however, the use of opportunistic screening is rising. Clinical and pathologic characteristics of 2168 Danish radical prostatectomy (RP) patients from Rigshospitalet, Copenhagen, Denmark, were compared with 2236 American RP patients from Stanford University Hospital, Stanford, CA, where PSA screening is ongoing. Despite recommendations against PSA screening in Denmark, Danish men undergoing RP at Rigshospitalet to a considerable extent now resemble American men undergoing RP at Stanford University Hospital. Purpose: To analyze how prostate-specific antigen (PSA) screening and practice patterns has affected trends in tumor characteristics in men undergoing radical prostatectomy (RP) in the United States and Denmark. Unlike in the United States, PSA screening has not been recommended in Denmark. Patients and Methods: We performed an observational register study using pre- and postoperative data on 2168 Danish patients from Rigshospitalet, Copenhagen, Denmark, and 2236 patients from Stanford University Hospital, Stanford, CA, who underwent RP between 1995 and 2013. Patients were stratified according to Cancer of the Prostate Risk Assessment—Postsurgical (CAPRA-S) risk groups and D'Amico risk classification and were clustered into 4 time periods (1995-1999, 2000-2004, 2005-2009, and 2010-2013). Temporal trends in the proportions of patients of a given variable at the 2 institutions were evaluated with Cochran-Armitage test for trends and chi-square testing. Results: A total of 4404 patients were included. Temporal changes in preoperative PSA, age, grade, and stage was found in both cohorts. Median preoperative PSA declined in both cohorts, while median age increased, with the Danish cohort showing the greatest changes in both PSA and age. In both cohorts, there was a trend for higher-risk preoperative features before RP over time. In 2010-2013, 27.7% and 21.8% of the patients were in the D'Amico high-risk group at Copenhagen and Stanford, respectively. Conclusion: Despite recommendation against PSA screening in Denmark, Danish men undergoing RP at Rigshospitalet to a considerable extent now resemble American men undergoing RP at Stanford. At both sites, there is continued trend to reduce the number of men undergoing RP for low-risk prostate cancer.
AB - Prostate-specific antigen (PSA) screening is not officially recommended for the detection of prostate cancer in Denmark; however, the use of opportunistic screening is rising. Clinical and pathologic characteristics of 2168 Danish radical prostatectomy (RP) patients from Rigshospitalet, Copenhagen, Denmark, were compared with 2236 American RP patients from Stanford University Hospital, Stanford, CA, where PSA screening is ongoing. Despite recommendations against PSA screening in Denmark, Danish men undergoing RP at Rigshospitalet to a considerable extent now resemble American men undergoing RP at Stanford University Hospital. Purpose: To analyze how prostate-specific antigen (PSA) screening and practice patterns has affected trends in tumor characteristics in men undergoing radical prostatectomy (RP) in the United States and Denmark. Unlike in the United States, PSA screening has not been recommended in Denmark. Patients and Methods: We performed an observational register study using pre- and postoperative data on 2168 Danish patients from Rigshospitalet, Copenhagen, Denmark, and 2236 patients from Stanford University Hospital, Stanford, CA, who underwent RP between 1995 and 2013. Patients were stratified according to Cancer of the Prostate Risk Assessment—Postsurgical (CAPRA-S) risk groups and D'Amico risk classification and were clustered into 4 time periods (1995-1999, 2000-2004, 2005-2009, and 2010-2013). Temporal trends in the proportions of patients of a given variable at the 2 institutions were evaluated with Cochran-Armitage test for trends and chi-square testing. Results: A total of 4404 patients were included. Temporal changes in preoperative PSA, age, grade, and stage was found in both cohorts. Median preoperative PSA declined in both cohorts, while median age increased, with the Danish cohort showing the greatest changes in both PSA and age. In both cohorts, there was a trend for higher-risk preoperative features before RP over time. In 2010-2013, 27.7% and 21.8% of the patients were in the D'Amico high-risk group at Copenhagen and Stanford, respectively. Conclusion: Despite recommendation against PSA screening in Denmark, Danish men undergoing RP at Rigshospitalet to a considerable extent now resemble American men undergoing RP at Stanford. At both sites, there is continued trend to reduce the number of men undergoing RP for low-risk prostate cancer.
KW - Prostate cancer
KW - PSA
KW - Radical prostatectomy
KW - Screening
KW - Urology
UR - http://www.scopus.com/inward/record.url?scp=85030565203&partnerID=8YFLogxK
U2 - 10.1016/j.clgc.2017.08.014
DO - 10.1016/j.clgc.2017.08.014
M3 - Journal article
C2 - 28988695
AN - SCOPUS:85030565203
SN - 1558-7673
VL - 16
SP - e181-e192
JO - Clinical Genitourinary Cancer
JF - Clinical Genitourinary Cancer
IS - 1
ER -
