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Initially, we extend our congratulations to Vaccarella at al. [1] for drawing attention to the phenomenon of prostate cancer overdiagnosis varying over time and across population and for insightful analysis of prostate cancer incidence and mortality in Europe. However, in the mentioned article, data on incidence regarding Poland is underestimated due to the fact that it is based only on Cancer Incidence in Five Continents XI [1,2], which only accounted for 31% of the Polish population in the years 2008-2012 (including data from selected regions of Poland: Świętokrzyskie, Wielkopolskie, Dolnośląskie, Lubelskie, and Podkarpackie). We have observed a similar phenomenon in Nicholas D James and colleagues' article “The Lancet Commission on prostate cancer: planning for the surge in cases" [3]. These publications utilize data estimates for Poland, despite the availability of reliable sources. For cancer cases, the Polish Cancer Registry (https://onkologia.org.pl/en/report) provides accurate information, while for mortality data, Statistics Poland (https://stat.gov.pl/en/) serves as a credible resource. We posit that the Polish National Cancer Registry (PNCR) [4] is more appropriate for examining the incidence and mortality rates of prostate cancer in the Polish population. Subsequently, we present comprehensive available data that accurately reflects the current state of prostate cancer incidence and mortality in Poland.
In Poland in 2021, as in other European countries, prostate cancer was the most common male cancer, accounting for almost 21% of all cancer cases in this group [5]. Prostate cancer incidence and mortality rates in Poland from 1999 to 2021, using data sourced from the Polish National Cancer Registry [4], presented as age-standardized mortality rates according to the standard population of the world (ASW), differs from the data presented by "Prostate cancer incidence and mortality in Europe and implications for screening activities: population-based study’ [1].
According to Vaccarella et al. [1], prostate cancer mortality in Poland began to increase after the early 2000s; however according to data from the PNCR, the mortality trend remained consistent during the initial decade of the twenty-first century. According to the PNCR report for 2021, prostate cancer is the second leading cause of cancer mortality in men, accounting for 11% of deaths, while lung cancer accounts for 26% of cancer deaths [5].
The prostate cancer incidence time trend according to Vaccarella et al. is constantly growing. According to PCNR data it was growing, except for the Covid-19 pandemic period, which Vaccarella and colleagues did not pay attention to. There are a few possible reasons for the increased number of prostate cancer patients in the aging population: increased participation in opportunistic PSA screening, better diagnostic methods, increasing health awareness in Polish society, and westernization of lifestyle (in particular, an increase in the percentage of obese people and little physical activity).
1. Vaccarella S, Li M, Bray F, et al. Prostate cancer incidence and mortality in Europe and implications for screening activities: population based study [published correction appears in BMJ. 2024 Sep 11;386:q1995. doi: 10.1136/bmj.q1995]. BMJ. 2024;386:e077738. Published 2024 Sep 4. doi:10.1136/bmj-2023-077738
2. Bray F, Colombet M, Ferlay J, et al., eds. Cancer Incidence in Five Conti-nents. Vol 11 (Electronic Version). Lyon: International Agency forResearch on Cancer; 2017.
3. James ND, Tannock I, N'Dow J, et al. The Lancet Commission on prostate cancer: planning for the surge in cases [published correction appears in Lancet. 2024 Apr 27;403(10437):1634. doi: 10.1016/S0140-6736(24)00748-7]. Lancet. 2024;403(10437):1683-1722. doi:10.1016/S0140-6736(24)00651-2.
4. Didkowska, J., Barańska, K., Miklewska, M. J., & Wojciechowska, U. (2024). Cancer incidence and mortality in Poland in 2023. Biuletyn Polskiego Towarzystwa Onkologicznego Nowotwory, 9(2), 87-105.
5. Miklewska MJ, Barańska K, Wojciechowska U, Sulkowska U, Tyczyński JE, Didkowska JA. Morbidity and mortality trends of the most common cancers in 1990–2019. Poland’s position compared to other European countries. Nowotwory. Journal of Oncology 2023;73(1):46-55
Competing interests:
No competing interests
14 September 2024
Iwona Wnętrzak
Urologist
Joanna A. Didkowska (Polish National Cancer Registry, Warsaw; Department of Epidemiology and Cancer Prevention, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw); Mateusz Czajkowski (Department of Urology, Medical University of Gdańsk, Gdańsk, Poland); Klaudia Barańska (Polish National Cancer Registry, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw; Faculty of Biomedical Engineering, Silesian University of Technology, Zabrze, Poland); Urszula Wojciechowska (Polish National Cancer Registry, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland)
Department of General and Oncological Urology, Praski Hospital, Warsaw, Poland
Accurate incidence and mortality rates for prostate cancer in Poland
Dear Editor,
Initially, we extend our congratulations to Vaccarella at al. [1] for drawing attention to the phenomenon of prostate cancer overdiagnosis varying over time and across population and for insightful analysis of prostate cancer incidence and mortality in Europe. However, in the mentioned article, data on incidence regarding Poland is underestimated due to the fact that it is based only on Cancer Incidence in Five Continents XI [1,2], which only accounted for 31% of the Polish population in the years 2008-2012 (including data from selected regions of Poland: Świętokrzyskie, Wielkopolskie, Dolnośląskie, Lubelskie, and Podkarpackie). We have observed a similar phenomenon in Nicholas D James and colleagues' article “The Lancet Commission on prostate cancer: planning for the surge in cases" [3]. These publications utilize data estimates for Poland, despite the availability of reliable sources. For cancer cases, the Polish Cancer Registry (https://onkologia.org.pl/en/report) provides accurate information, while for mortality data, Statistics Poland (https://stat.gov.pl/en/) serves as a credible resource. We posit that the Polish National Cancer Registry (PNCR) [4] is more appropriate for examining the incidence and mortality rates of prostate cancer in the Polish population. Subsequently, we present comprehensive available data that accurately reflects the current state of prostate cancer incidence and mortality in Poland.
In Poland in 2021, as in other European countries, prostate cancer was the most common male cancer, accounting for almost 21% of all cancer cases in this group [5]. Prostate cancer incidence and mortality rates in Poland from 1999 to 2021, using data sourced from the Polish National Cancer Registry [4], presented as age-standardized mortality rates according to the standard population of the world (ASW), differs from the data presented by "Prostate cancer incidence and mortality in Europe and implications for screening activities: population-based study’ [1].
According to Vaccarella et al. [1], prostate cancer mortality in Poland began to increase after the early 2000s; however according to data from the PNCR, the mortality trend remained consistent during the initial decade of the twenty-first century. According to the PNCR report for 2021, prostate cancer is the second leading cause of cancer mortality in men, accounting for 11% of deaths, while lung cancer accounts for 26% of cancer deaths [5].
The prostate cancer incidence time trend according to Vaccarella et al. is constantly growing. According to PCNR data it was growing, except for the Covid-19 pandemic period, which Vaccarella and colleagues did not pay attention to. There are a few possible reasons for the increased number of prostate cancer patients in the aging population: increased participation in opportunistic PSA screening, better diagnostic methods, increasing health awareness in Polish society, and westernization of lifestyle (in particular, an increase in the percentage of obese people and little physical activity).
1. Vaccarella S, Li M, Bray F, et al. Prostate cancer incidence and mortality in Europe and implications for screening activities: population based study [published correction appears in BMJ. 2024 Sep 11;386:q1995. doi: 10.1136/bmj.q1995]. BMJ. 2024;386:e077738. Published 2024 Sep 4. doi:10.1136/bmj-2023-077738
2. Bray F, Colombet M, Ferlay J, et al., eds. Cancer Incidence in Five Conti-nents. Vol 11 (Electronic Version). Lyon: International Agency forResearch on Cancer; 2017.
3. James ND, Tannock I, N'Dow J, et al. The Lancet Commission on prostate cancer: planning for the surge in cases [published correction appears in Lancet. 2024 Apr 27;403(10437):1634. doi: 10.1016/S0140-6736(24)00748-7]. Lancet. 2024;403(10437):1683-1722. doi:10.1016/S0140-6736(24)00651-2.
4. Didkowska, J., Barańska, K., Miklewska, M. J., & Wojciechowska, U. (2024). Cancer incidence and mortality in Poland in 2023. Biuletyn Polskiego Towarzystwa Onkologicznego Nowotwory, 9(2), 87-105.
5. Miklewska MJ, Barańska K, Wojciechowska U, Sulkowska U, Tyczyński JE, Didkowska JA. Morbidity and mortality trends of the most common cancers in 1990–2019. Poland’s position compared to other European countries. Nowotwory. Journal of Oncology 2023;73(1):46-55
Competing interests: No competing interests