NEOPLASTIC AND BORDERLINE LESIONS OF THE PROSTATE - AUTOPSY STUDY ANDEPIDEMIOLOGIC DATA

Early detection and management of prostatic cancer (PC) is an importan t public health problem in all industrialized countries, where the rel ative rate of the elderly population is rapidly increasing. We examine d the epidemiology of PC in the province of Trieste, Italy and studied the relationship between prostatic intraepithelial neoplasia (PIN) an d PC. The average annual incidence of PC was 99.3 per 100,000 (1,739 n ew prostatic cancer cases were histologically diagnosed at autopsy or in surgical specimens between 1980 and 1993). In patients over 85 year s of age, the incidence rate was 1,209 per 100,000 compared with 64 pe r 100,000 in the 55-64 age group. Trends in PC incidence rates showed a significant increase among men under 64 years of age and those betwe en 65-74 years. Survival analysis showed that 94% of the patients with well differentiated PC were alive at 5 years, compared with 80% and 4 0% of those with moderately differentiated and poorly differentiated c ancer, respectively. We studied 130 whole autopsy prostates, 70 radica l prostatectomies with carcinoma, 63 transurethral resections or adeno mectomies without cancer from patients who later developed PC and 94 t ransurethral resections or adenomectomies from patients who did not de velop PC. The 102 prostatic cases with cancer had a high rate of PIN, and the relative frequency of PIN 3 was high (almost 70%, versus almos t 0% in benign prostates). lit addition, the frequency of PIN was high er in benign prostates of patients who later developed PC (almost 50% of the cases) than in benign autopsy and surgical prostates. PIN was s patially associated with cancer in 75% of the cases. This study confir ms the strong relationship between PIN and PC.