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Canadian Journal of Public Health

, Volume 97, Issue 3, pp 177–182 | Cite as

Trends in Prostate Cancer Incidence, Hospital Utilization and Surgical Procedures, Canada, 1981–2000

  • C. Ineke Neutel
  • Ru-Nie Gao
  • Paul A. Blood
  • Leslie A. Gaudette
Research

Abstract

Background: Numbers of new prostate cancer cases in Canada continue to increase because of increasing prostate cancer incidence, population growth, aging of the population, and earlier detection methods such as PSA (prostate-specific antigen) testing. Concern has been expressed that PSA-related increases in incidence will make unaffordable demands on Canadian hospital resources. Our objective is to relate increases in prostate cancer incidence to trends in hospitalizations and in- patient treatment.

Methods: Hospitalizations with prostate cancer as primary diagnosis were obtained from the Hospital Morbidity Database, estimates of prostate cancer day surgery from the Discharge Abstract Database, newly diagnosed cases from the Canadian Cancer Registry, and prostate cancer deaths from the Vital Statistics Mortality Databases — all for the years 1981–2000.

Results: Between 1981–2000, the number of new cases rose from 7,000 to 18,500 with a transient peak, 1991–1994. Hospitalizations rose parallel to the incidence until 1991 but then fell sharply in spite of further increasing incidence. The use of radical prostatectomy (RP) increased steadily, but transurethral prostatectomy and bilateral orchiectomy decreased in the 1990s. Decreases in length of stay and in number of hospitalizations resulted in considerably decreased annual hospital days for all prostate cancer in-patient procedures except RP, which remained level since 1993.

Conclusions: A net decrease in number of in-patient days occurred, despite the increasing number of new prostate cancer cases and the increasing use of radical prostatectomy. We concluded that increases in hospital utilization due to early detection programs, such as PSA testing, are unlikely to overwhelm in-patient services of Canadian hospitals.

MeSH terms

Trends prostate cancer surgery hospital utilization prostatectomy Orchiectomy 

Résumé

Contexte: Le nombre de nouveaux cas de cancer de la prostate au Canada continue d’augmenter annuellement. Au nombre des raisons qui expliquent cette augmentation, on compte la hausse de l’incidence du cancer de la prostate, la croissance et le vieillissement de la population, ainsi que des méthodes de dépistage qui détectent le cancer de la prostate à un stade plus précoce, telles que le test de dépistage de l’antigène prostatique spécifique (PSA). On a exprimé des inquiétudes quant au fait que les augmentations de l’incidence des résultats positifs au test PSA entraîneront des demandes inabordables pour les ressources hospitalières canadiennes. Notre objectif consiste à établir un lien entre les augmentations de l’incidence du cancer de la prostate et les tendances relatives aux hospitalisations et aux traitements prodigués aux patients hospitalisés.

Méthode: Nous avons obtenu, pour la période qui s’échelonne de 1981 à 2000, a) le nombre d’hospitalisations liées au cancer de la prostate comme diagnostic primaire à partir de la Base de données sur la morbidité hospitalière, b) le nombre estimatif de chirurgies d’un jour pratiquées chez des personnes atteintes du cancer de la prostate à partir de la Base de données sur les congés des patients (BDCP), c) le nombre de cas nouvellement diagnostiqués à partir du Registre canadien du cancer, et d) le nombre de personnes qui sont décédées des suites du cancer de la prostate à partir des bases de données sur les décès des statistiques de l’état civil.

Résultats: De 1981 à 2000, le nombre de nouveaux cas est passé de 7 000 à 18 500, atteignant un sommet transitoire pendant la période de 1991 à 1994. Jusqu’en 1991, le nombre d’hospitalisations a augmenté au même rythme que l’incidence, pour ensuite chuter brusquement, malgré une incidence de plus en plus élevée. L’utilisation de la prostatectomie radicale a augmenté de façon constante, tandis que la prostatectomie transurétrale et l’orchidectomie bilatérale ont diminué au cours des années 90. Les diminutions de la durée des séjours à l’hôpital et du nombre d’hospitalisations ont entraîné une diminution considérable du nombre de jours d’hospitalisation par année pour toutes les interventions pratiquées chez des patients hospitalisés atteints du cancer de la prostate, à l’exception de la prostatectomie radicale, qui est demeurée au même niveau depuis 1993.

Conclusions: Malgré le fait que le nombre de nouveaux cas de cancer de la prostate soit en augmentation et que la prostatectomie radicale soit de plus en plus pratiquée, on constate qu’il y a eu une nette diminution de la durée d’hospitalisation des patients. Nous en sommes arrivés à la conclusion qu’il est peu probable que les augmentations dans l’utilisation des services hospitaliers en raison des programmes de dépistage du cancer de la prostate à un stade précoce, tels que le test PSA, aient pour effet de submerger les services aux patients hospitalisés dans les hôpitaux du Canada.

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Copyright information

© The Canadian Public Health Association 2006

Authors and Affiliations

  • C. Ineke Neutel
    • 1
    • 2
  • Ru-Nie Gao
    • 1
  • Paul A. Blood
    • 3
  • Leslie A. Gaudette
    • 1
  1. 1.Chronic Disease Management and Control DivisionCentre for Chronic Disease Prevention and Control, Public Health Agency of CanadaOttawaCanada
  2. 2.Department of Epidemiology and Community MedicineUniversity of OttawaCanada
  3. 3.Department of Radiation OncologyBC Cancer Agency - Vancouver Island CentreVictoriaCanada

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