American Journal of Epidemiology Advance Access originally published online on July 7, 2006
American Journal of Epidemiology 2006 164(4):376-384; doi:10.1093/aje/kwj213
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Original Contribution |
Reduction of Prostate Cancer Mortality in Tyrol, Austria, after Introduction of Prostate-specific Antigen Testing
1 Cancer Registry of Tyrol, Innsbruck, Austria
2 Institute of Quality Science, University of Health Informatics and Technology Tyrol, Innsbruck, Austria
3 Department for Urology, Innsbruck Medical University, Innsbruck, Austria
4 Institute of Immunology and Transfusion Medicine, Innsbruck Medical University, Innsbruck, Austria
Reprint requests to Dr. Willi Oberaigner, Cancer Registry of Tyrol, Anichstr. 35, A-6020 Innsbruck, Austria (e-mail: willi.oberaigner{at}iet.at).
The objective of this study was to analyze in detail the time trend in prostate cancer mortality in the population of Tyrol, Austria. In Tyrol, prostate-specific antigen tests were introduced in 1988–1989 and, since 1993, have been offered to all men aged 45–74 years free of charge. More than three quarters of all men in this age group had at least one such test in the last decade. The authors applied the age-period-cohort model by Poisson regression to mortality data covering more than three decades, from 1970 to 2003. For Tyrol, the full model with age and period and cohort terms fit fairly well. Period terms showed a significant reduction in prostate cancer mortality in the last 5 years, with a risk ratio of 0.81 (95% confidence interval: 0.68, 0.98) for Tyrol; for Austria without Tyrol, no effect was seen, with a risk ratio of 1.00 (95% confidence interval: 0.95, 1.05). Each was compared with the mortality rate in the period 1989–1993. Although the results of randomized screening trials are not expected until 2008–2010, these findings support the evidence that prostate-specific antigen testing offered to a population free of charge can reduce prostate cancer mortality.
Austria; mortality; prostate-specific antigen; prostatic neoplasms
Abbreviations: APC, age-period-cohort; ASR age-standardized rate; PSA, prostate-specific antigen
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