{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T16:39:00Z","timestamp":1781800740029,"version":"3.54.5"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T00:00:00Z","timestamp":1749600000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100007505","name":"Kirsten and Freddy Johansen Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007505","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,6,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Prostate cancer survival varies across Nordic countries, potentially reflecting variation in stage distribution at diagnosis. To highlight the variation in the diagnostic intensity of prostate cancer, we outlined the differences in stage distributions at diagnosis across these countries. Specifically, we evaluated whether the variation in cancer survival could be attributed to differences in stage at diagnosis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>In this population-based cohort study, we identified 243\u200a893 men diagnosed with prostate cancer from 2004 to 2016 in Denmark, Iceland, Norway, and Sweden. Country-specific stage distributions at diagnosis were obtained from individual cancer registry records provided by the NORDCAN collaboration. Relative survival and 95% confidence intervals (CIs) were estimated by using the Pohar Perme estimator. Stage-standardized relative survival was estimated by applying pre-weighting based on the stage distribution of the entire Nordic cohort.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The stage distribution of prostate cancer varied between the Nordic countries, with the highest proportion of early-stage (0\u2013I) cases in Sweden and the highest proportion of advanced-stage (IV) cases in Denmark. When adjusting for differences in stage distribution (i.e. stage standardization), the 5-year relative survival improved in Denmark and Norway within the study period (2004\u201317), increasing from 83.9% (95% CI, 83.2\u201384.6) and 91.4% (95% CI, 90.8\u201392.0) to 87.3 (95% CI, 86.5\u201388.2) and 93.4% (95% CI, 92.8\u201394.1). Conversely, the 5-year relative survival declined in Sweden from 90.6% (95% CI, 90.3\u201391.0) to 88.5% (95% CI, 88.0\u201389.1).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The distinct differences in stage distributions between the Nordic countries substantially contributed to the variation in prostate cancer survival.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ije\/dyaf082","type":"journal-article","created":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T13:07:41Z","timestamp":1751029661000},"source":"Crossref","is-referenced-by-count":1,"title":["Stage-standardized and stage-specific survival among men with prostate cancer in the Nordic countries 2004\u201316: the NORDCAN survival studies"],"prefix":"10.1093","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9522-7678","authenticated-orcid":false,"given":"Signe Benzon","family":"Larsen","sequence":"first","affiliation":[{"name":"Copenhagen Prostate Cancer Center, Department of Urology, Copenhagen University Hospital \u2014 Rigshospitalet , Copenhagen,","place":["Denmark"]},{"name":"Section of Epidemiology, Department of Public Health, University of Copenhagen , Copenhagen,","place":["Denmark"]},{"name":"Cancer Survivorship, Danish Cancer Institute, Danish Cancer Society , Copenhagen,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7061-7178","authenticated-orcid":false,"given":"Frida E","family":"Lundberg","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics, Karolinska Institutet , Stockholm,","place":["Sweden"]},{"name":"Department of Oncology-Pathology, Karolinska Institutet , Stockholm,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00f8ren","family":"Friis","sequence":"additional","affiliation":[{"name":"Cancer Epidemiology and Surveillance, Danish Cancer Institute, Danish Cancer Society , Copenhagen,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helgi","family":"Birgisson","sequence":"additional","affiliation":[{"name":"Icelandic Cancer Registry , Reykjavik,","place":["Iceland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8644-9041","authenticated-orcid":false,"given":"Therese M -L","family":"Andersson","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics, Karolinska Institutet , Stockholm,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5337-6234","authenticated-orcid":false,"given":"Gerda","family":"Engholm","sequence":"additional","affiliation":[{"name":"Cancer Epidemiology and Surveillance, Danish Cancer Institute, Danish Cancer Society , Copenhagen,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5337-663X","authenticated-orcid":false,"given":"Paul C","family":"Lambert","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics, Karolinska Institutet , Stockholm,","place":["Sweden"]},{"name":"Biostatistics Research Group, Department of Health Sciences, University of Leicester , Leicester,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6562-6416","authenticated-orcid":false,"given":"Klaus","family":"Brasso","sequence":"additional","affiliation":[{"name":"Copenhagen Prostate Cancer Center, Department of Urology, Copenhagen University Hospital \u2014 Rigshospitalet , Copenhagen,","place":["Denmark"]},{"name":"Department of Clinical Medicine, University of Copenhagen , Copenhagen,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Pettersson","sequence":"additional","affiliation":[{"name":"Swedish Cancer Registry, National Board of Health and Welfare , Stockholm,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"El\u00ednborg","family":"\u00d3lafsd\u00f3ttir","sequence":"additional","affiliation":[{"name":"Icelandic Cancer Registry , Reykjavik,","place":["Iceland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom B\u00f8rge","family":"Johannesen","sequence":"additional","affiliation":[{"name":"Cancer Registry of Norway , Oslo,","place":["Norway"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon M","family":"K\u00f8nig","sequence":"additional","affiliation":[{"name":"Cancer Epidemiology and Surveillance, Danish Cancer Institute, Danish Cancer Society , Copenhagen,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1191-7231","authenticated-orcid":false,"given":"Anna L V","family":"Johansson","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics, Karolinska Institutet , Stockholm,","place":["Sweden"]},{"name":"Cancer Registry of Norway , Oslo,","place":["Norway"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6506-2569","authenticated-orcid":false,"given":"Lina Steinrud","family":"M\u00f8rch","sequence":"additional","affiliation":[{"name":"Cancer and Medicine, Danish Cancer Institute, Danish Cancer Society , Copenhagen,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,6,17]]},"reference":[{"key":"2025062709073882900_dyaf082-B1","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J Clin"},{"key":"2025062709073882900_dyaf082-B2","author":"Lar\u00f8nningen"},{"key":"2025062709073882900_dyaf082-B3","doi-asserted-by":"crossref","first-page":"1984","DOI":"10.1016\/j.ejca.2013.01.008","article-title":"Differences in survival from prostate cancer in Denmark, Iceland and Sweden","volume":"49","author":"Brasso","year":"2013","journal-title":"Eur J Cancer"},{"key":"2025062709073882900_dyaf082-B4","doi-asserted-by":"crossref","first-page":"2228","DOI":"10.1002\/ijc.30924","article-title":"Prostate and breast cancer in four Nordic countries: a comparison of incidence and mortality trends across countries and age groups 1975\u20132013","volume":"141","author":"Kv\u00e5le","year":"2017","journal-title":"Int J Cancer"},{"key":"2025062709073882900_dyaf082-B5","doi-asserted-by":"crossref","first-page":"1266","DOI":"10.1080\/0284186X.2020.1822544","article-title":"Trends in cancer survival in the Nordic countries 1990\u20132016: the NORDCAN survival studies","volume":"59","author":"Lundberg","year":"2020","journal-title":"Acta Oncol"},{"key":"2025062709073882900_dyaf082-B6","doi-asserted-by":"crossref","first-page":"e484","DOI":"10.1016\/S1470-2045(14)70211-6","article-title":"Prevention and early detection of prostate cancer","volume":"15","author":"Cuzick","year":"2014","journal-title":"Lancet Oncol"},{"key":"2025062709073882900_dyaf082-B7","doi-asserted-by":"crossref","first-page":"725","DOI":"10.3109\/02841861003782017","article-title":"NORDCAN\u2014a Nordic tool for cancer information, planning, quality control and research","volume":"49","author":"Engholm","year":"2010","journal-title":"Acta Oncol"},{"key":"2025062709073882900_dyaf082-B8","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1080\/0284186X.2023.2189528","article-title":"Influence of various assumptions for the individual TNM components on the TNM stage using Nordic cancer registry data","volume":"62","author":"Engholm","year":"2023","journal-title":"Acta Oncol"},{"key":"2025062709073882900_dyaf082-B9","doi-asserted-by":"crossref","first-page":"5336","DOI":"10.1002\/cncr.25537","article-title":"TNM seventh edition: what\u2019s new, what\u2019s changed.","volume":"116","author":"Sobin","year":"2010","journal-title":"Cancer"},{"key":"2025062709073882900_dyaf082-B10","doi-asserted-by":"crossref","first-page":"303","DOI":"10.2340\/1651-226X.2024.35232","article-title":"TNM stage in the Nordic Cancer Registries 2004\u20132016: Registration and availability","volume":"63","author":"Engholm","year":"2024","journal-title":"Acta Oncol"},{"key":"2025062709073882900_dyaf082-B11","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1111\/j.1541-0420.2011.01640.x","article-title":"On estimation in relative survival","volume":"68","author":"Perme","year":"2012","journal-title":"Biometrics"},{"key":"2025062709073882900_dyaf082-B12","doi-asserted-by":"crossref","first-page":"101745","DOI":"10.1016\/j.canep.2020.101745","article-title":"Estimation of age-standardized net survival, even when age-specific data are sparse","volume":"67","author":"Rutherford","year":"2020","journal-title":"Cancer Epidemiol"},{"key":"2025062709073882900_dyaf082-B13","doi-asserted-by":"crossref","first-page":"2004","DOI":"10.1002\/(SICI)1097-0142(19961101)78:9<2004::AID-CNCR23>3.0.CO;2-#","article-title":"An alternative approach to monitoring cancer patient survival","volume":"78","author":"Brenner","year":"1996","journal-title":"Cancer"},{"key":"2025062709073882900_dyaf082-B14","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1080\/21681805.2019.1681503","article-title":"Educational level and first-time PSA testing in general practice","volume":"53","author":"Lerhmann-Lerche","year":"2019","journal-title":"Scand J Urol"},{"key":"2025062709073882900_dyaf082-B15","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1111\/bju.16211","article-title":"Opportunistic prostate-specific antigen testing in Norwegian men: a public health challenge","volume":"133","author":"Albertsen","year":"2024","journal-title":"BJU Int"},{"key":"2025062709073882900_dyaf082-B16","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1016\/j.eururo.2014.12.006","article-title":"Opportunistic testing versus organized prostate-specific antigen screening: outcome after 18 years in the G\u00f6teborg randomized population-based prostate cancer screening trial","volume":"68","author":"Arnsrud Godtman","year":"2015","journal-title":"Eur Urol"},{"key":"2025062709073882900_dyaf082-B17","doi-asserted-by":"crossref","first-page":"e0308254","DOI":"10.1371\/journal.pone.0308254","article-title":"Spatio-temporal variation in prostate cancer testing in Stockholm: a population-based study","volume":"19","author":"Rai","year":"2024","journal-title":"PLoS One"},{"key":"2025062709073882900_dyaf082-B18","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1016\/S1470-2045(10)70146-7","article-title":"Mortality results from the G\u00f6teborg randomised population-based prostate-cancer screening trial","volume":"11","author":"Hugosson","year":"2010","journal-title":"Lancet Oncol"},{"key":"2025062709073882900_dyaf082-B19","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1080\/21681805.2021.1881612","article-title":"The G\u00d6TEBORG prostate cancer screening 2 trial: a prospective, randomised, population-based prostate cancer screening trial with prostate-specific antigen testing followed by magnetic resonance imaging of the prostate","volume":"55","author":"Kohestani","year":"2021","journal-title":"Scand J Urol"},{"key":"2025062709073882900_dyaf082-B20","doi-asserted-by":"crossref","first-page":"1667","DOI":"10.1016\/S1470-2045(15)00361-7","article-title":"Prostate cancer screening in men aged 50\u201369 years (STHLM3): a prospective population-based diagnostic study","volume":"16","author":"Gr\u00f6nberg","year":"2015","journal-title":"Lancet Oncol"}],"container-title":["International Journal of Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ije\/article-pdf\/54\/4\/dyaf082\/63511059\/dyaf082.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ije\/article-pdf\/54\/4\/dyaf082\/63511059\/dyaf082.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T13:07:44Z","timestamp":1751029664000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ije\/article\/doi\/10.1093\/ije\/dyaf082\/8166026"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,11]]},"references-count":20,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,6,11]]}},"URL":"https:\/\/doi.org\/10.1093\/ije\/dyaf082","relation":{},"ISSN":["1464-3685"],"issn-type":[{"value":"1464-3685","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,8]]},"published":{"date-parts":[[2025,6,11]]},"article-number":"dyaf082"}}