Prostate cancer (PCa) was the leading incident cancer and 3rd leading cause of cancer death in men in France in 2015 with inter-regional disparities. The objectives were to describe PCa incidence and mortality in France and by region, using real life data from the National Health Data System and to identify the factors associated with all-cause or PCa-specific mortality.
Men aged ≥ 18years hospitalized and/or on long-term care for PCa (ICD-10 code C61) in France between 2010 and 2021 were included. An incident case was defined by the absence of any cancer in the five years preceding the first coding. Incidence and mortality estimates were age-standardized: France 2018f standardized rates (FSR), all-cause mortality (SMR) and PCa-specific mortality (SMRspe). Factors associated with death were identified using cause-specific Cox models.
The mean annual incidence was 47,081cases/year (FSR:179.6/100,000men), increasing over the period except 2020. All-cause mortality was 20,259 deaths/year (77.3/100,000men), and PCa-specific mortality was 7,265 deaths/year (27.7/100,000men). A PCa-specific mortality excess was found in Centre-Val-de-Loire (SMRspe = 1.21), Bretagne (1.18), Hauts-de-France (1.17) Normandie (1.15). After adjustment, significant PCa mortality excess was observed in Bretagne (HR = 1,29;95%IC[1.09-1.46]) and Hauts-de-France (HR = 1.19[1.03-1.34]). The other factors associated with death were an age ≥ 60years, an increasing comorbidity index, metastatic disease at onset (major weight in specific mortality with hazard ratio HR = 16.1[15.2-17.0]), precariousness, affiliation to the agricultural scheme, and the COVID period in all-cause mortality.
This study updated incidence and mortality data in France. It showed differences in mortality between regions in France. The adjustment moderates regional findings based on raw mortality data.
World journal of urology. 2024 Oct 28*** epublish ***
Hugo Crespin, Anne-Isabelle Lecuyer, Emeline Laurent, Franck Bruyere, Leslie Grammatico-Guillon
Urology Department, Teaching Hospital of Tours, Faculty of Medicine, University of Tours, Tours, France. ., Epidemiology Unit for Clinical Data in Centre-Val de Loire (EpiDcliC) Teaching Hospital of Tours, Research Team EA 7505 "Education, Ethics, Health", University of Tours, Tours, France., Urology Department, Teaching Hospital of Tours, Faculty of Medicine, University of Tours, Infectiology Committee of the French Urology Association (CIAFU), Tours, France., Epidemiology Unit for Clinical Data in Centre-Val de Loire (EpiDcliC), Teaching Hospital of Tours, Faculty of Medicine, University of Tours, Infectiology Committee of the French Urology Association (CIAFU), Tours, France.