Cytogenetics of Prostate Cancer

In mosl Weslern counlries, proslale cancer (PC) is a common malignancy. In Ihe United Siaies cancer slatistics of 1994, PC has Ihe highesl incidence rale and is Ihe Ihird cause of cancer dealhs [Boring el al '94J. In Ihe Nelherlands, which lakes Ihe ninlh place on Ihe IIsl of PC cancer dealhs by counlry, PC is currently Ihe second cause of cancer morbidity and dealh behind lung cancer [Van der Gulden el al '94J. Over Ihe lasl decades, Ihe incidence and mortality rales of PC show a sleady Increase in mosl areas of Ihe world. In Ihe Nelherlands Ihe age adjusled mortality has risen 1.5-fold since 1950. Van der Gulden el al. have shown in Ihelr report on Ihe PC relaled mortalily Irend in Ihe Nelherlands a continuous increase of risk in Ihe period 1950-1989. There is evidence Ihallhis effeclls partly based on Ihe successive Improvemenls in urological diagnostics, which caused an increase of Ihe delection rale. However, beller delection does nol necessarily mean larger mortalily figures. Early delection can cause a shift lowards localized disease. For inslance, in Norway, an increase of Ihe 5-year survival rale was reported [Zaridze el al '84J. Siudy of Ihe incidence and morlalily Irends can conlribule 10 a clearer underslandlng of Ihe faclors predisposing for PC. Hislologic PC -Ihe lerm proposed by Carter [Carter el al '90AJ 10 describe PC Ihal is found in many older men al aulopsy- has a similar prevalence Ihroughoullhe world. The prevalence of clinical PC however, is greally differenl among counlries, from abou15/100,OOO in Japan 10 100/100,000 in Ihe U.S. If only tumor growth would be required to cause a hislological PC 10 progress 10 a clinical cancer, Ihe incidence rales would be Ihe same everywhere. Because they are nol, It is clear Ihal olher crucially important faclors are responsible.