We report nationwide real-life practice in the management of prostate cancer (PC) in France in a population of 4936750 men. All prostate-specific antigen (PSA) blood tests performed between 2006 and 2018 were recorded in a National Health registry, which allowed to identify 692516 men diagnosed with PC and a control population consisting of 3899509 men without PC.
PSA tests, age at diagnosis, treatments, and survival were analysed. Their management was analysed by age range and compared in the different French regions. Disparities were found in age at PSA testing and management approaches (surveillance, and local and systemic therapies). We found that 50% of men had received five PSA blood tests, but the first PSA test was taken late in life, with a peak in the decade between 65 and 75 yr of age. Adoption of monitoring was low (12%). Older men appeared to receive a late diagnosis with reduced chances of curative therapy and a subsequent increase in mortality, but cautious interpretation of our data is warranted in view of competing morbidities and other causes of death. The incidence of metastases at diagnosis, indicated by the use of systemic therapies, increased progressively from 2011 onwards. PATIENT SUMMARY: In this study, we report nationwide real-life practice in the management of prostate cancer (PC) in France in a population of 4936750 men, including 692516 patients with PC. We found that the first prostate-specific antigen test is taken too late in life, leading to a late diagnosis with reduced chances of curative therapy and a subsequent increase in mortality.
European urology oncology. 2024 Mar 11 [Epub ahead of print]
Olivier Cussenot, Yoann Taille, Jean-Jacques Portal, Géraldine Cancel-Tassin, Morgan Roupret, Alexandre de la Taille, Guillaume Ploussard, Romain Mathieu, Freddie C Hamdy, Eric Vicaut
Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK; CeRePP, Paris, France. Electronic address: ., Clinical Research Unit, AP-HP. Nord - University Paris Cité, Paris, France., CeRePP, Paris, France; GRC n°5 Predictive Onco-Urology, AP-HP, Sorbonne Université, Paris, France., Department of Urology, AP-HP, Hopitaux Universitaires Henri Mondor, University of Creteil, Créteil, France., Department of Urology, La Croix du Sud Hospital, Quint Fonsegrives, France., Department of Urology, CHU Rennes, Rennes, France., Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.
PubMed http://www.ncbi.nlm.nih.gov/pubmed/38472031