Significant Decline in Prostate Cancer Mortality in the Nordic Countries

The study discusses improvements in both the treatment and diagnosis of prostate cancer as likely causes for the decline in mortality. Aiming to present updated mortality trends and discuss possible reasons for the observed changes, researchers used registry data from the Nordic countries. They also compared the latest available rates from the Nordic countries (from 2022) with those from other European countries.

The mortality rate of prostate cancer has significantly decreased in the Nordic countries over the past decades, and these countries are no longer among those with the highest prostate cancer mortality rates in Europe. In 2022, Norway had the second-lowest mortality rate among the Nordic countries overall, and the lowest among people under 85 years old.

Read the full study: View of Considerable decline in prostate cancer mortality in Nordic countries after 2000 (Acta Oncologica)

In the mid-1990s, with a peak in Norway in 1996, the Nordic countries were among those with the highest prostate cancer mortality rates in the world. Although there has been greater variation in incidence than in mortality in Europe since the late 1980s, mortality has generally decreased in many countries.

"Since the mid-1990s, there have been significant changes in the diagnosis and treatment of prostate cancer," says researcher and lead author of the study, Rune Kvåle.

Age and Mortality

Fortunately, the mortality rate among younger men is very low. Nearly 40% of those who die from prostate cancer in the Nordic countries are over 85 years old. Nevertheless, 16,649 men under the age of 85 died from prostate cancer in the five-year period 2018–2022 in the Nordic countries.

"Because it has been shown that the reported cause of death among the very oldest can be incorrect, we compared mortality changes for all men versus those under the age of 85. We found that the mortality rate for those under 85 had decreased even more than for all men. In Norway, the mortality rate for men under 85 has decreased by almost 60% since the mid-1990s," says Kvåle.

Lowest Mortality Rates in Norway and Finland

A total of 27,318 people over the age of 40 had prostate cancer reported as the underlying cause of death during the five-year period 2018–2022 in the Nordic countries. A total of 16,649 (61%) of these were in the age group 40–84 years. 

Mortality rates decreased from the mid-1990s in Norway and Finland, from the late 1990s in Sweden and Iceland, and from around 2002 in Denmark. From 2000 to 2022, the mortality rate for men over the age of 40 decreased the least in Denmark by 1.6% per year and the most in Norway by 3.1% per year.

In Norway, Sweden, Iceland, and Finland, the mortality rate of prostate cancer for those under the age of 85 has roughly halved from the second half of the 1990s to today, while the rates in Denmark have decreased somewhat less since the beginning of this millennium. 

Over the past decade, the decline has been fastest in Sweden and Norway. In 2022, Norway had the second-lowest mortality rate among the Nordic countries overall, and the lowest rate for those under the age of 85.

Improved Cancer Care

Several possible causes for the decline in mortality are discussed in the article, such as earlier diagnosis and improved treatment.

"It is likely that the significant reduction in mortality we see is the sum of positive effects from both earlier and more effective curative treatment and improved treatment of metastatic prostate cancer," concludes Kvåle.