Prostate cancer incidence and mortality in Navarre (Spain).

BACKGROUND: Prostate cancer is one of the most commonly diagnosed malignancies among males worldwide. In this study, overall and age-specific incidence and mortality trends are analyzed in order to present the past and current epidemiological situation of the disease in Navarre (Spain). METHODS: Population-based incidence data from the 1975-2010 period, provided by the Cancer Registry of Navarre and prostate cancer specific mortality data for 1975-2013, provided by the Spanish Statistical Office, were used in the analysis. Age-standardized incidence and mortality rates, change-points and annual percentage changes (APC) were estimated by joinpoint regression analysis. One-dimensional P-spline models were used to estimate projections up to 2016. RESULTS: Considerable increases of cancer incidence rates in men aged 45-74 years were observed, with APC of +4.5% (p<0.001), +9.5% (p<0.001) and +2.4% (p<0.05) in the 1975-1990, 1990-2000 and 2000-2010 periods, respectively. In the older than 74 age-group, an increase of incidence rates in the 1975-1999 period was registered (APC +3.3%, p<0.001), followed by a significant decrease up to 2010 (APC -4.0%, p<0.01). Mortality rates rose until 1995 (APC +2.2%, p<0.001) whereas a decline occurred afterwards up to 2013 (APC -3.4%, p<0.001). CONCLUSION: Even though overall prostate cancer incidence rates seem to have stabilized in 2002-2010 in Navarra, trends were different by age groups: increased in men 45-74 years old and decreased in the 75+ year age-group. A decline in mortality rates was observed in both age groups since about 1995. Changes in the use of prostate specific antigen test for screening in oncoming years could affect future prostate cancer trends.

[Incidence and mortality due to cancer in Navarre, 1998-2002. Trends in the last 30 years]. / Incidencia y mortalidad por cáncer en Navarra, 1998-2002. Evolución en los últimos 30 años.

Between 1998-2002, 16,952 new cases of cancer were registered in Navarre. In men, the most frequently diagnosed cancers were in the following order: prostate, lung, colon and rectum, bladder and stomach, which accounted for 63.2%. In women, the sites were breast, colon and rectum, corpus uteri, stomach and ovary, which accounted for 57.6% of the cases. In the same period, 1998-2002, 4,127 men and 2,470 women died from cancer. Sixty percent of all deaths due to malign tumours in men were due to cancer of the lung, prostate, colon and rectum, stomach and bladder. In women this was due to cancers of colon and rectum, breast, stomach, pancreas and lung, which accounted for 49% of the cases. In men in Navarre there has been an increase in the incidence rates of cancer of the prostate, kidney and non-Hodgkin lymphoma. Avoidable cancers such as those related to smoking (lung, oral cavity and pharynx or pancreas) continue to rise, and represent a greater global risk of dying from cancer in the latest period studied than in the decades of the 1970s and 1980s. From 1995 up to the present, mortality due to cancer has moved from occupying the second place to become the first cause of death among men in Navarre. The global risk of death due to cancer in men is now equal to the first period studied, 1975-1977. Amongst women the global risk of death due to cancer fell by 25% between 1975 and 2002, basically at the cost of breast and stomach cancer. Tumours related to smoking increased both in mortality and in incidence and appear as a significant health problem amongst women in Navarre. Breast cancer has increased in incidence, with lower mortality figures than those of the first period 1975-1977. Invasive cancer of the cervix remains at very low rates in comparison with many European countries, including Spain. In both sexes colorectal and skin cancer has increased, while the incidence and mortality of stomach cancer continues to fall.

[Recent trends of the main causes of death in Navarre. 1995-2004]. / Tendencias recientes de las principales causas de muerte en Navarra. 1995-2004.

UNLABELLED: We present the statistics for mortality in Navarre for the 1995-2004 period by sex, age and cause of death. METHODS: The data proceeds from the statistical bulletins on death. The 1995-1999 period is compared with the 2000-2004 period, using adjusted rates to the population of Navarre for the year 2001 and the rate of potential years of life lost between 0-70 years adjusted to the European population. RESULTS: Life expectancy at birth in the 2000-2004 period was 77.9 years in men and 85 years in women, the latter being one of the highest registered at the world level. Infant mortality fell to 3.3 per 1,000 living newborn infants. The risk of death has fallen in practically all age groups, with a notable fall in mortality of 40% in the 25-34 group at the cost of AIDS. There has been a significant increase of mortality due to lung cancer amongst women under 65 years of age (46%) in the 2000-2004 period with respect to the previous five year period and a sharp fall in mortality due to breast cancer (45.4%). In both sexes there has been a continued fall of mortality due to cerebrovascular diseases, ischaemic heart diseases, cardiac failure and arteriosclerosis and of mortality due to ulcer and cirrhosis. The rates of mortality in Navarre in all the main groups of causes are lower than those of Europe, except for the rate of mortality due to external causes. CONCLUSIONS: The increase of mortality due to lung cancer and other cancers related to smoking, due to the spread of consumption in recent decades, could have a negative influence on the life expectancy of women in Navarre in coming years. The prevention of mortality due to external causes and the prevention of deaths linked to tobacco consumption are the two priorities that emerge from the data on mortality in this autonomous community.