Population-based studies in Prostate Cancer data Base Sweden (PCBaSe) EXTenD. Life expectancy and longterm effects of screening and treatment of prostate cancer in older men

Prostate cancer is the most common cancer in older men in Sweden, median age at diagnosis is 70-years and 82-years at prostate cancer death. In older men the effects of screening i.e the balance between ‘costs’ and benefits is delicate.

The disease course of prostate cancer is often long, it will take up to 40-years of  follow-up in order to assess all effects of screening and treatment. Therefore, simulations are needed in addition to trials and studies based on observed data.

The aim of this project is to simulate how to best screen for prostate cancer and how to treat men with prostate cancer with an emphasis on older men and how to identify healthy older men who would  benefit  from screening and treatment.

We will take advantage of the large variations over time and between the 21 regions in Sweden in use of PSA testing to investigate the effect of different intensities of screening by PSA testing.We will collect data on PSA testing etc from all 21 regions in Sweden and we will link the created database with health care registers to create a study file.

We will also renew and extend linkages in our fifth iteration of PCBaSe that will now include with 250 000 cases and 1 million control men. This is  the world’s most comprehensive prostate cancer database and we will use it to simulate long-term outcomes.

Finally, we will optimize prediction of life expectancy in order to identify healthy older men who would benefit from screening, diagnosis, and treatment.