Epidemiology of Prostate Cancer in Europe

  • Ruben G. Cremers
  • Lambertus A. Kiemeney


Prostate cancer is the most frequently diagnosed cancer in European men. Incidence rates vary hugely between continents, with differences up to 100-fold. Northern and Western Europe are among the parts of the world with the highest incidence, whereas Asia has the lowest incidence. Also between countries within a continent, considerable variation exists. This variation is caused by a combination of genetic factors, dietary and lifestyle factors, and health-seeking behavior, the latter most notably opportunistic prostate cancer testing with PSA. The mechanisms underlying the risk factors remain to be elucidated. The same goes for the question whether PSA screening should be advocated.

In all European countries, prostate cancer incidence has been increasing since even before the discovery of PSA. Interestingly, different trends are seen for mortality. In the more western and northern European countries, mortality rates started to decrease sometime in the 1990s, while a continuously increasing mortality has been observed in the southern and eastern countries. Following the increased detection of early prostate cancer and improvements in treatment, currently, almost five million European men are estimated to be alive with a diagnosis of prostate cancer, a number still increasing, making it one of the largest health issues in the Western world for the twenty-first century.


Prostate Cancer Baltic State Prostate Cancer Incidence Prostate Cancer Survival Prostate Cancer Mortality 
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.


  1. Aly M, Wiklund F, Xu J et al (2011) Polygenic risk score improves prostate cancer risk prediction: results from the stockholm-1 cohort study. Eur Urol 60(1):21–28PubMedCrossRefGoogle Scholar
  2. Andriole GL, Bostwick DG, Brawley OW et al (2010) Effect of dutasteride on the risk of prostate cancer. N Engl J Med 362(13):1192–1202PubMedCrossRefGoogle Scholar
  3. Bartsch G, Horninger W, Klocker H et al (2001) Prostate cancer mortality after introduction of prostate-specific antigen mass screening in the Federal State of Tyrol, Austria. Urology 58(3):417–424PubMedCrossRefGoogle Scholar
  4. Bosland MC (2000) The role of steroid hormones in prostate carcinogenesis. J Natl Cancer Inst Monogr 27:39–66PubMedCrossRefGoogle Scholar
  5. Bosland MC, Cremers RG, Kiemeney LA (2010) Words of wisdom. Re: effect of dutasteride on the risk of prostate cancer. Eur Urol 58(4):631–632PubMedCrossRefGoogle Scholar
  6. Bray F, Lortet-Tieulent J, Ferlay J et al (2010) Prostate cancer incidence and mortality trends in 37 European countries: an overview. Eur J Cancer 46(17):3040–3052PubMedCrossRefGoogle Scholar
  7. Carter BS, Bova GS, Beaty TH et al (1993) Hereditary prostate cancer: epidemiologic and clinical features. J Urol 150(3):797–802PubMedGoogle Scholar
  8. Cook LS, Goldoft M, Schwartz SM et al (1999) Incidence of adenocarcinoma of the prostate in Asian immigrants to the United States and their descendants. J Urol 161(1):152–155PubMedCrossRefGoogle Scholar
  9. Couto E, Boffetta P, Lagiou P et al (2011) Mediterranean dietary pattern and cancer risk in the EPIC cohort. Br J Cancer 104(9):1493–1499PubMedCrossRefGoogle Scholar
  10. Cremers RG, Karim-Kos HE, Houterman S et al (2010) Prostate cancer: trends in incidence, survival and ­mortality in the Netherlands, 1989–2006. Eur J Cancer 46(11):2077–2087PubMedCrossRefGoogle Scholar
  11. de Vries E, Karim-Kos HE, Janssen-Heijnen ML et al (2010) Explanations for worsening cancer survival. Nat Rev Clin Oncol 7(1):60–63PubMedCrossRefGoogle Scholar
  12. Duffield-Lillico AJ, Dalkin BL, Reid ME et al (2003) Selenium supplementation, baseline plasma selenium status and incidence of prostate cancer: an analysis of the complete treatment period of the nutritional ­prevention of cancer trial. BJU Int 91(7):608–612PubMedCrossRefGoogle Scholar
  13. Ferlay J, Shin HR, Bray F et al (2010) GLOBOCAN 2008 v1.2, cancer incidence and mortality worldwide: IARC cancerbase no. 10 [Internet]. Available from Accessed 11/07/2011
  14. Iwasaki M, Mameri CP, Hamada GS et al (2008) Secular trends in cancer mortality among Japanese immigrants in the state of Sao Paulo, Brazil, 1979–2001. Eur J Cancer Prev 17(1):1–8PubMedCrossRefGoogle Scholar
  15. Karim-Kos HE, de Vries E, Soerjomataram I et al (2008) Recent trends of cancer in Europe: a combined approach of incidence, survival and mortality for 17 cancer sites since the 1990s. Eur J Cancer 44(10):1345–1389PubMedCrossRefGoogle Scholar
  16. Langeberg WJ, Isaacs WB, Stanford JL (2007) Genetic etiology of hereditary prostate cancer. Front Biosci 12:4101–4110PubMedCrossRefGoogle Scholar
  17. Lippman SM, Klein EA, Goodman PJ et al (2009) Effect of selenium and vitamin E on risk of prostate cancer and other cancers: the selenium and vitamin E cancer prevention trial (SELECT). JAMA 301(1):39–51PubMedCrossRefGoogle Scholar
  18. Sakr WA, Grignon DJ, Crissman JD et al (1994) High grade prostatic intraepithelial neoplasia (HGPIN) and prostatic adenocarcinoma between the ages of 20–69: an autopsy study of 249 cases. In Vivo 8(3):439–443PubMedGoogle Scholar
  19. Sanchez-Chapado M, Olmedilla G, Cabeza M et al (2003) Prevalence of prostate cancer and prostatic intraepithelial neoplasia in caucasian mediterranean males: an autopsy study. Prostate 54(3):238–247PubMedCrossRefGoogle Scholar
  20. Sant M, Aareleid T, Berrino F et al (2003) EUROCARE-3: survival of cancer patients diagnosed 1990–94–results and commentary. Ann Oncol 14(Suppl 5):v61–v118PubMedCrossRefGoogle Scholar
  21. Soos G, Tsakiris I, Szanto J et al (2005) The prevalence of prostate carcinoma and its precursor in hungary: an autopsy study. Eur Urol 48(5):739–744PubMedCrossRefGoogle Scholar
  22. Sorum PC, Shim J, Chasseigne G et al (2003) Why do primary care physicians in the United States and France order prostate-specific antigen tests for asymptomatic patients? Med Decis Making 23(4):301–313PubMedCrossRefGoogle Scholar
  23. Stamey TA, Yang N, Hay AR et al (1987) Prostate-specific antigen as a serum marker for adenocarcinoma of the prostate. N Engl J Med 317(15):909–916PubMedCrossRefGoogle Scholar
  24. Thompson IM, Goodman PJ, Tangen CM et al (2003) The influence of finasteride on the development of prostate cancer. N Engl J Med 349(3):215–224PubMedCrossRefGoogle Scholar
  25. Varghese JS, Easton DF (2010) Genome-wide association studies in common cancers–what have we learnt? Curr Opin Genet Dev 20(3):201–209PubMedCrossRefGoogle Scholar
  26. Venkateswaran V, Klotz LH (2010) Diet and prostate ­cancer: mechanisms of action and implications for chemoprevention. Nat Rev Urol 7(8):442–453PubMedCrossRefGoogle Scholar
  27. Verdecchia A, Francisci S, Brenner H et al (2007) Recent cancer survival in Europe: a 2000–02 period analysis of EUROCARE-4 data. Lancet Oncol 8(9):784–796PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  1. 1.Department of Epidemiology, Biostatistics and HTA (133)Radboud University Medical CentreNigmegenThe Netherlands

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