REICAP: prospective epidemiologic study of prostate cancer in Italy. Preliminary results. Ricerca Epidemiologica Italiana sul Carcinoma Prostatico.

Abstract

Prostatic carcinoma is a common disease of aging male subjects. Owing to structural population changes, its incidence is increasing, making it a major social problem. Epidemiological studies are useful but often do not fully rely on clinical data. The purpose of the present study was to investigate characteristics of prostatic carcinoma from both a clinical and epidemiological point of view. A multiphased clinicoepidemiological study was initiated in Italy, involving 26 urological centers operating in districts where national tumor registries are active. Demographic and clinical data on stage, pathology, prostate-specific antigen (PSA), and first-line treatment of 819 patients recruited during the prospective 1-year clinical phase of the study were examined. The study showed that most patients with prostate carcinoma were symptomatic, that incidental cases were 10% and distant metastases were present at first observation in 15.3% of patients. PSA within the normal range was found in about 60% of incidental cases and in about a third of stage B cases. Most patients were treated with hormonal therapy. Radical surgery showed a limited incidence of capsular involvement and lymph node metastases. These preliminary data show that in Italy, prostate carcinoma is diagnosed mainly when symptoms are present and that in 53% of cases the disease is locally advanced or disseminated. Treatment appears quite homogeneous for advanced cases but controversies exist for stage A1 (19% treated with hormones, 23% with radical surgery and 52% with watchful waiting), for stage A2 (52% treated with hormones, 23% with watchful waiting), and for stage B (58% of B2 treated with hormones against 27% only treated with radical prostatectomy). A special analysis is planned to investigate the cause of the low incidence of capsular invasions and D1 in operated cases.