Objective: To gain insight into the incidence and treatment of prostate cancer.
Design: Descriptive.
Setting: Comprehensive Cancer Centre Amsterdam, the Netherlands.
Methods: All prostate cancers diagnosed in 1989-1994 in residents of the region of the CCCA (North Holland and Flevoland) were selected from the regional cancer registry data base. Cases from one hospital were excluded due to incomplete registration.
Results: There was a 38% increase in the number of diagnosed prostate carcinomas between 1989 (n = 671) and 1994 (n = 929). Median age at diagnosis was 74 years. The proportion of localized tumours remained at the level of 69% during this period. The percentages of localized T1 tumours and tumours with unknown T stage decreased, while the percentages of localized T2 and T3 tumours increased. There was a sixfold increase in the number of total prostatectomies. 77% of the operated patients were diagnosed with a T2 tumour, 11% with a T3 tumour. At the end of the study period total prostatectomy was the main treatment of T1/2 prostate cancers in men below the age of 60. T3 tumours and men between 60 and 75 years of age were more often treated with radiotherapy, while men over 75 were mainly treated hormonally. The percentage of localized prostate cancers observed strongly increased with age and with lower T stage.
Conclusion: The sharp rise in the number of prostate cancers during the period 1989-1994 was not confined to early stages. Within a few years total prostatectomy became one of the main treatment modalities in localized prostate cancer. This treatment was mainly restricted to younger men with smaller localized prostate carcinomas.