Effects of Prostate Cancer Screening and Treatment
(Effecten van prostaatkanker screening en behandeling)
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Prostate cancer is the second most frequently diagnosed cancer of men worldwide. The number of new cases worldwide was estimated at 899,000 and accounted for 13.6% of all cancers in men in 2008. With an estimated 258,000 deaths in 2008, prostate cancer is the sixth leading cause of death from cancer in men (6.1% of the total).1 Prostate cancer is most common in Australia/New Zealand, Northern and Western Europe, and Northern America (Figure 1.1). The incidence of prostate cancer has been rising in these regions since the early nineties largely because of the widespread practice of PSA testing. Especially in the US the incidence increased rapidly after the introduction of prostate specific antigen (PSA) testing. While incidence also increased in the Netherlands, the increase was less dramatic than in the US (Figure 1.2). Prostate cancer mortality rates have been decreasing since 1996 in both the Netherlands and the US (Figure 1.2). Possible explanations for this trend are improvements in prostate cancer treatment and screening for prostate cancer.
The studies reported in this thesis were primarily funded by the National Cancer Institute and the Netherlands Organisation of Health Research and Development (ZonMw). For any grant pertaining to specific studies the reader is referred to the individual papers published in their respective journals. This thesis was printed with financial support of the J.E. Jurriaanse Stichting, the Department of Public Health Erasmus MC Rotterdam and the Erasmus University Rotterdam.
- prostate cancer
- psa screening