Cancer of the prostate (ICD-9 185)

The incidence of prostatic cancer shows one of the largest variations among all sites studied. The highest rates exceeded 500/10⁶ in Iceland and Sweden while the rates in Russia and Belarus were 100/10⁶. The variation in mortality rates was markedly smaller: the mortality/incidence ratio varies from 0.5 in Russia to less than 0.4 in Iceland and Sweden.

There was not much difference in the age-specific mortality rates between the countries before the age of 75. No increase was seen in the mortality rate in the post-socialistic countries after the age of 75, whereas in all other countries also among the very old, the steep increase by age continued. In incidence rates there was already some difference between the countries in ages below 50, but the relative difference increased with age.

The aetiology of prostatic cancer is poorly understood. The level of diagnostic activity (frequency of thin-needle biopsies among non-symptomatic men) greatly affects the incidence rate and explains some of the spatial variation. The differences in mortality are hard to explain. There were no population-wide organised screening programmes in the 1980s in any of the countries which would have affected our results.