• J. M. G. Wilson
Part of the Clinical Practice in Urology book series (PRACTICE UROLOG)


Despite being one of the most common cancers among Western males, the etiology of carcinoma of the prostate remains elusive. Epidemiologic studies provide intriguing clues but the combination that will release the lock and reveal the mystery has yet to be found. To a greater or lesser extent, age, race, geography, sexual activity, hormone levels, diet, trace metals, and virus infections may all play a part in establishing the risk of developing prostatic cancer. But it is in the nature of epidemiologic studies that, while demonstrating associations, they stop short of providing the vital links between cause and effect; for this, biologic studies are necessary. This chapter attempts to summarize the present state of epidemiologic knowledge, to bring together some of the world data on survival, and to analyze published work on clinical and pathologic survival studies. Excellent extended reviews of the epidemiology by Owen (1976), Mandel and Schuman (1980), Alderson (1981), Greenwald (1982), and Mettlin (1983) have been published elsewhere. However, before discussing these and other questions it may be helpful to consider aspects of data collection and interpretation that are fundamental to understanding the epidemiologic picture: first, the problems of large-scale data collection by many different centers, and the comparability of their data; and second, the nature of epidemiologic information itself, where the relationship between prevalence, incidence, mortality, and survival merits interpretation.


Benign Prostatic Hyperplasia Relative Survival Rate Cancer Registration Observe Survival Rate Information Service Division 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Alderson MR (1981) Epidemiology. In: Duncan W (ed) Prostate cancer. Springer, Berlin Heidelberg New York, pp 1–19 (Recent results in cancer research, vol 78 )Google Scholar
  2. Armenian HK, Lilienfeld AM, Diamond EL, Bross IDJ (1974) Relation between benign prostatic hyperplasia and cancer of the prostate. Lancet 11: 115–117CrossRefGoogle Scholar
  3. Armstrong B, Doll R (1975) Environmental factors and cancer incidence and mortality in different countries, with special reference to dietary practices. Int J Cancer 15: 617–631PubMedCrossRefGoogle Scholar
  4. Ashley DJB (1965) On the incidence of carcinoma of the prostate. J Pathol Bact 90: 217–224CrossRefGoogle Scholar
  5. Axtell LM, Cutler SJ, Myers MH (1972) (eds) End results in cancer, report No. 4. National Cancer Institute, Bethesda Md [DHEW Publication No. (NIH) 73–272]Google Scholar
  6. Axtell LM, Asire AJ, Myers MH (1976) (eds) Cancer patient survival report No. 5: a report from the cancer surveillance, epidemiology and end results (SEER) program. National Cancer Institute, Bethesda Md [DHEW Publication No. (NIH) 77–992]Google Scholar
  7. Belt E, Schroeder FH (1972) Total perineal prostatectomy for carcinoma of the prostate. J Urol 107: 91–96PubMedGoogle Scholar
  8. Berg JW (1975) Can nutrition explain the pattern of international epidemiology of hormone-dependent cancers? Cancer Res 35: 3345–3350PubMedGoogle Scholar
  9. Blair A, Fraumeni JF (1978) Geographic patterns of prostate cancer in the United States. J Natl Cancer Inst 61: 1379–1384PubMedGoogle Scholar
  10. Breslow N, Chan CW, Dhom G et al. (1977) Latent carcinoma of prostate at autopsy in seven areas. Int J Cancer 20: 680–688PubMedCrossRefGoogle Scholar
  11. Byar DP (1975) Benign prostatic hyperplasia and cancer of the prostate. Lancet 1: 866PubMedCrossRefGoogle Scholar
  12. Byar DP (1977) VACURG studies on prostatic cancer and its treatment. In: Tannenbaum M (ed) Urologic pathology: the prostate. Lea & Febiger, New York, pp 241–267Google Scholar
  13. Byar DP, Mostofi FK (1969) Cancer of the prostate in men less than 50 years old: an analysis of 51 cases. J Urol 102: 726–733PubMedGoogle Scholar
  14. Byar DP, Mostofi FK (1972) Carcinoma of the prostate: prognostic evaluation of certain pathologic features in 208 radical prostatectomies. Cancer 30: 5–13PubMedCrossRefGoogle Scholar
  15. Chisholm GD (1983) Perspectives and prospects. In: Duncan W (ed) Prostate cancer. Springer, Berlin Heidelberg New York, pp 173–184 (Recent results in cancer research, vol 78 )Google Scholar
  16. Cochrane AL, Holland WW (1971) Validation of screening procedures. In: Acheson ED (ed) Epidemiology of non-communicable disease. Br Med Bull 27: 3–8Google Scholar
  17. Cook GB, Watson FR (1968) A comparison by age of death rates due to prostate cancer alone. J Urol 100: 669–671PubMedGoogle Scholar
  18. Corriere JN, Cornog JL, Murphy JJ (1970) Prognosis in patients with carcinoma of the prostate. Cancer 25: 911–918PubMedCrossRefGoogle Scholar
  19. Cutler SJ, Young JL (1975) Third national cancer survey: incidence data. National Cancer Institute Monograph 41 [DHEW Pub. No. (NIH) 75–787], Table 5Google Scholar
  20. Enstrom JE, Austin DF (1977) Interpreting cancer survival rates. Science 195: 847–857PubMedCrossRefGoogle Scholar
  21. Faul P (1982) Experience with the German annual preventive check-up examination. In: Jacobi GH (ed) International perspectives in urology, vol 3: Prostate cancer. Williams & Wilkins, Baltimore Md, pp 57–68Google Scholar
  22. Franks LM (1956) Latency and progression in tumours: the natural history of prostate cancer. Lancet 11: 1037–1039CrossRefGoogle Scholar
  23. Franks LM (1974) Benign prostatic hyperplasia. Lancet 11: 293CrossRefGoogle Scholar
  24. Gilbertsen VA (1971) Cancer of the prostate gland: results of early diagnosis and therapy undertaken for cure of the disease. JAMA 215: 81–84PubMedCrossRefGoogle Scholar
  25. Greenwald P (1982) Prostate. In: Schottenfeld D, Fraumeni JF (eds) Cancer epidemiology and prevention. WB Saunders, New York, pp 938–946Google Scholar
  26. Greenwald P, Kirmss V, Polan AK, Dick VS (1974) Cancer of the prostate among men with benign prostatic hyperplasia. J Natl Cancer Inst 53: 335–340PubMedGoogle Scholar
  27. Hakulinen T, Pukkala E, Hakama M, Lehtonen M, Saxen E, Teppo L (1981) Survival of cancer patients in Finland in 1953–1974. Ann Clin Res 13 [Suppl 31]: 59–61Google Scholar
  28. Hanash KA, Utz DC, Cook EN, Taylor WF, Titus JL (1972) Carcinoma of the prostate: a 15-year follow-up. J Urol 107: 450–453PubMedGoogle Scholar
  29. Harrison GSM (1983) The prognosis of prostatic cancer in the younger man. Br J Urol 55: 315–320PubMedCrossRefGoogle Scholar
  30. Hirayama T (1979) Epidemiology of prostate cancer with special reference to the role of diet. In: National Cancer Institute Monograph 53: Second Symposium on Epidemiology and Cancer Registries in the Pacific Basin. National Cancer Institute, Bethesda Md, pp 149–155Google Scholar
  31. Howell MA (1974) Factor analysis of international cancer mortality data and per capita food consumption. Br J Cancer 29: 323–336CrossRefGoogle Scholar
  32. Johnson DE, Lanieri JP, Ayala AG (1972) Prostatic adenocarcinoma occurring in men under 50 years of age. J Surg Oncol 4: 207–216PubMedCrossRefGoogle Scholar
  33. Krain LS (1974) Some epidemiologic variables in prostatic carcinoma in California. Prev Med 3: 154–159PubMedCrossRefGoogle Scholar
  34. Lancet (1974) Screening for disease: a series reprinted from the Lancet. 5 October–21 DecemberGoogle Scholar
  35. Lea AJ (1967) Neoplasms and environmental factors. Ann R Coll Surg Engl 41: 432–437PubMedGoogle Scholar
  36. Lilienfeld AM, Levin ML, Kessler II (1972) Cancer in the United States, APHA monograph. Harvard University Press, Cambridge, MassGoogle Scholar
  37. Mandel JS, Schuman LM (1980) Epidemiology of cancer of the prostate. In: Lilienfeld AM (ed) Reviews in cancer epidemiology, vol 1. Elsevier/North Holland, New York, pp 1–83Google Scholar
  38. Mettlin C (1983) Cancer of the prostate and testis. In: Bourke GJ (ed) The epidemiology of cancer. Croom Helm, London; The Charles Press, Philadelphia, pp 245–259Google Scholar
  39. Nuffield Provincial Hospitals Trust (1968) Screening in medical care: reviewing the evidence. Oxford University Press, LondonGoogle Scholar
  40. Office of Population Censuses and Surveys/Cancer Research Campaign (1981) Cancer statistics: incidence, survival and mortality in England and Wales. Studies on Medical and Population Subjects No. 43. HMSO, London, pp 79–82Google Scholar
  41. Office of Population Censuses and Surveys (1980, 1982, 1983a, 1983b, 1984 ) Mortality statistics: cause, England and Wales. Series DH2, Nos 6–10, Table 3. HMSO, LondonGoogle Scholar
  42. Office of Population Censuses and Surveys (1982) Cancer statistics: survival. 1971–1975 registrations, England and Wales. HMSO, London, p 29Google Scholar
  43. Owen WL (1976) Cancer of the prostate: a literature review. J Chron Dis 29: 89–114PubMedCrossRefGoogle Scholar
  44. Registrar General, Scotland (1984) Annual report 1983. HMSO, Edinburgh, Table C 1. 4Google Scholar
  45. Rosenberg SE (1965) Is carcinoma of the prostate less serious in older men? J Am Geriatr Soc 13: 791–798PubMedGoogle Scholar
  46. Schuman LM, Mandel JS, Blackard C, Bauer H, Scarlett J, McHugh R (1977) Epidemiologic study of prostatic cancer: preliminary report. Cancer Treat Rep 61: 181–186PubMedGoogle Scholar
  47. Scottish Health Service Common Services Agency, Information Services Division (1984) Scottish health statistics 1983. HMSO, EdinburghGoogle Scholar
  48. Segi M, Hattori H, Noye H, Segi R (1981) Age-adjusted death rates for cancer for selected sites (A-classification) in 40 countries in 1976. Segi Institute of Cancer Epidemiology, Nagoya, Japan, Fig 1–14Google Scholar
  49. Silber I, McGavran MH (1971) Adenocarcinoma of the prostate in men less than 56 years old: a study of 65 cases. J Urol 105: 283–285PubMedGoogle Scholar
  50. Steele R, Lees REM, Kraus AS, Rao C (1971) Sexual factors in the epidemiology of cancer of the prostate. J Chron Dis 24: 29–37PubMedCrossRefGoogle Scholar
  51. Tjaden HB, Culp DA, Flocks RH (1965) Clinical adenocarcinoma of the prostate in patients under 50 years of age. J Urol 93: 618–621PubMedGoogle Scholar
  52. Turner RD, Belt E (1957) A study of 229 consecutive cases of total perineal prostatectomy for cancer of the prostate. J Urol 77: 62–77PubMedGoogle Scholar
  53. Waterhouse J, Muir C, Shanmugaratnam K, Powell J (1982) Cancer incidence in five continents, vol 4. I ARC Scientific Publications No, 42, International Agency for Research on Cancer, LyonGoogle Scholar
  54. Williams RD, Blackard CE (1974) Benign prostatic hyperplasia and cancer of the prostate. Lancet 11: 1265CrossRefGoogle Scholar
  55. Wilson JMG, Jungner G (1968) Principles and practice of screening for disease. World Health Organization: Public Health Papers 34. World Health Organization, Geneva, SwitzerlandGoogle Scholar
  56. Wilson JMG, Kemp IW, Stein GJ (1984) Cancer of the prostate: do younger men have a poorer survival rate? Br J Urol 56: 391–396PubMedCrossRefGoogle Scholar
  57. Woolf CM (1960) An investigation of the familial aspects of carcinoma of the prostate. Cancer 13: 739–744PubMedCrossRefGoogle Scholar
  58. World Health Organization (1977) International classification of diseases, 9th edn., vol 1. World Health Organization, Geneva, pp 699–730Google Scholar
  59. Wynder EL, Hyams L, Shigematsu T (1967) Correlations of international cancer death rates. Cancer 20: 113–126PubMedCrossRefGoogle Scholar
  60. Wynder EL, Mabuchi K, Whitmore WF (1971) Epidemiology of cancer of the prostate. Cancer 28: 344–360PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1987

Authors and Affiliations

  • J. M. G. Wilson

There are no affiliations available

Personalised recommendations