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Prostate Cancer Mortality Higher in U.K. Than U.S.

Dramatic decline in mortality in United States coincides with increased uptake of screening test

FRIDAY, April 18 (HealthDay News) -- There was a dramatic decline in prostate cancer mortality in the United States from 1994 to 2004, which coincided with a significant increase in uptake of prostate-specific antigen testing and which was not mirrored in the United Kingdom, according to a report published online April 17 in The Lancet Oncology.

Simon M. Collin, of the University of Bristol in Bristol, U.K., and colleagues analyzed prostate cancer mortality data from 1975 to 2004 for both countries in order to identify inflection points in mortality trends.

In the early 1990s, mortality peaked in both countries at almost identical rates, but after 1994, rates declined in the United States by 4.17 percent a year, compared with only a 1.14 percent annual decline in the United Kingdom after 1992. By 2000, death rates among U.K. patients over 75 years of age had plateaued, whereas U.S. rates continued their sustained decline at the rate of 5.32 percent a year. The mean ratio of prostate cancer incidence in the United States versus the United Kingdom peaked at the time when prostate-specific antigen testing was introduced in the United States.

"Explanations for the different trends in mortality include the possibility of an early effect of initial screening rounds on men with more aggressive asymptomatic disease in the U.S.A., different approaches to treatment in the two countries and bias related to the misattribution of cause of death," the authors conclude.

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