A recent study examining prostate cancer trends across 26 European countries has provided vital data for the ongoing discussions around implementing EU-wide screening programs. Conducted between 1980 and 2017, the study reveals significant variations in prostate cancer incidence and mortality rates, largely linked to the use of prostate-specific antigen (PSA) testing. The findings underscore the importance of carefully planning any future screening efforts to minimize the risks associated with overdiagnosis.
The study, which included men aged 35 to 84, shows that prostate cancer incidence rates varied widely across Europe. In the mid-2000s, incidence rates peaked with notable disparities between countries, ranging from 46 cases per 100,000 men in Ukraine to 336 per 100,000 in France. The variations in incidence rates were closely associated with the introduction and increased use of PSA testing. However, these rates began to decline in several countries after 2005, though recent years have shown a resurgence in some regions.
In contrast, mortality rates from prostate cancer were much lower and more stable than incidence rates. The study highlights a steady decline in mortality across most countries, with less variation between nations compared to incidence rates. For example, while prostate cancer incidence showed up to a 20-fold difference between countries, mortality rates displayed only a fivefold variation.
This stark difference between incidence and mortality suggests that PSA testing has contributed to overdiagnosis—detecting low-risk prostate cancers that are unlikely to progress or pose a threat to the patient’s life. The study’s authors caution that while PSA testing can help reduce prostate cancer mortality, it may also lead to unnecessary diagnoses and treatments, which can lower men’s quality of life due to side effects from treatments like surgery or radiation.
As the European Union considers expanding PSA-based screening under its Beating Cancer Plan, the study provides critical evidence for designing future programs. The findings emphasize the need for careful implementation to avoid the pitfalls of overdiagnosis. The study recommends that future screening initiatives include follow-up testing, such as magnetic resonance imaging (MRI), to better identify cases that require intervention while reducing unnecessary treatments for indolent cancers.
Overall, the research offers a comprehensive baseline assessment of prostate cancer epidemiology across Europe. It highlights the importance of balancing the benefits of early detection with the risks of overdiagnosis, ensuring that future screening programs are both effective and safe.
Disclosures: This article was created by the touchONCOLOGY team utilizing AI as an editorial tool (ChatGPT (GPT-4o) [Large language model]. https://chat.openai.com/chat.) The content was developed and edited by human editors. No funding was received in the publication of this article.
