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Title: Estimation of artefactual and true components of the trend in prostate cancer incidence in Scotland, 1982-1990
Author: Al-Sayyad, Jamal Jaffar J.
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 1998
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Prostate cancer is becoming an increasingly important health problem in Scotland. Its reported incidence increased substantially over the past two decades. Mortality rates also increased but less rapidly than incidence. The aim of the study is to describe the incidence trends in Scotland between 1971 - 1990 and to estimate the artefactual increases due to ageing, improved reporting and increased detection of TURP-detected incidental cases, and the true component in the overall trend. More than 90% of cases with an SMRI for PCa were reported to SCR at the end compared to 86% at the beginning of the study. Clinical PCa constituted the majority of all registered cases, but incidental incidence rate increased dramatically (70%) as opposed to 5.7% increase in the clinical PCa incidence. Analysis of the trend shows that out of (540) total increase in annual registrations between 1982-84 and 1988-90, 24.3% (131 cases) could be explained by improvement in reporting, 34% (184 cases) due to increased detection of incidental cases, 35% (190 cases) due to ageing and 6.5% (35 cases) remain to be explained and may be due to untested components or a genuine increase. More than half of the increase in incidence of PCa is artefactual which is not surprising given the dramatic rise in TURP and the plausibility of improved reporting. The clinical disease also increased, though much slower, reflecting perhaps a real increase in prevalence of risk factors. While the artefactual part is reassuring from the public health point of view, for policy makers and finance managers it is a case for arguing against the relative importance of PCa. This, however, has to be considered in the light of similar artefacts in other cancers and some other diseases. The actual increase is present indicating that the disease is to be taken seriously and ways of reducing its morbidity and consequent fatality need to be explored.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available