{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T18:43:55Z","timestamp":1788201835989,"version":"build-2803163510"},"reference-count":36,"publisher":"MJS Publishing, Medical Journals Sweden AB","license":[{"start":{"date-parts":[[2025,2,27]],"date-time":"2025-02-27T00:00:00Z","timestamp":1740614400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SJU"],"abstract":"<jats:p>Background: Swedish national guidelines provide evidence-based recommendations for standard of care; however, little is known about adherence to them. The aim of this study was to assess adherence to management guidelines for prostate cancer (PCa).\nMaterials and methods: Data in the National Prostate Cancer Register (NPCR), that includes 98% of all incident PCa cases in Sweden, were used to analyse adherence to national PCa guidelines for men diagnosed between 2010 and 2023. A selection of quality indicators displayed on the public web page of NPCR were assessed.\nResults: Active surveillance in men with low-risk PCa and an estimated life expectancy &gt;10 years increased from 44% in 2010 to 88% in 2023. Radical treatment for men with localised high-risk PCa and life expectancy &gt;10 years increased from 60% in 2010 to 86% in 2023 and for men with locally advanced PCa and life expectancy &gt;5 years from 37% in 2010 to 64% in 2023. The proportion of radical prostatectomies for low- or intermediate-risk PCa performed with nerve-sparing technique increased from 61% in 2015 to 87% in 2023. Use of adjuvant androgen deprivation therapy after radiotherapy for men with high-risk or locally advanced PCa increased five-fold from 14% in 2010 to 73% in 2022.\nConclusion: Adherence to recommendations in national guidelines improved in Sweden between 2010 and 2023. Public, open reporting of NPCR data on adherence to guidelines down to department level is likely to have contributed to these improvements.<\/jats:p>","DOI":"10.2340\/sju.v60.43107","type":"journal-article","created":{"date-parts":[[2025,2,27]],"date-time":"2025-02-27T12:36:48Z","timestamp":1740659808000},"page":"50-58","source":"Crossref","is-referenced-by-count":8,"title":["Improved adherence to prostate cancer guidelines concomitant with public reporting. Nationwide population-based study"],"prefix":"10.2340","volume":"60","author":[{"given":"Andri Wilberg","family":"Orrason","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Scilipoti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"Garmo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rolf","family":"Gedeborg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johan","family":"Styrke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus","family":"Westerberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1183","published-online":{"date-parts":[[2025,2,27]]},"reference":[{"key":"100956","unstructured":"EAU Guidelines. Presented at the EAU Annual Congress; Milan; 2023. ISBN 978-94-92671-19-6"},{"key":"100957","unstructured":"National Board of Health and Welfare. National Swedish guidelines on prostate cancer [Internet]. Available from: https:\/\/cancercentrum.se\/samverkan\/cancerdiagnoser\/prostata\/vardprogram\/ [cited 15.12.2024]"},{"key":"100958","doi-asserted-by":"crossref","unstructured":"Stattin P. How to improve cancer care by use of guidelines and quality registers. Scand J Urol. 2024;59:190\u2013192. https:\/\/doi.org\/10.2340\/sju.v59.42272","DOI":"10.2340\/sju.v59.42272"},{"key":"100959","doi-asserted-by":"crossref","unstructured":"Stranne J. 2023\/2024 update of the national prostate cancer guidelines in Sweden. Scand J Urol. 2024;59:210\u2013211. https:\/\/doi.org\/10.2340\/sju.v59.42656","DOI":"10.2340\/sju.v59.42656"},{"key":"100960","doi-asserted-by":"crossref","unstructured":"Stattin P, Sandin F, Loeb S, et al. Public online reporting from a nationwide population-based clinical prostate cancer register. BJU Int. 2018;122:8\u201310. https:\/\/doi.org\/10.1111\/bju.14213","DOI":"10.1111\/bju.14213"},{"key":"100961","unstructured":"The National Prostate Cancer Register. Koll p\u00e5 l\u00e4get [Internet]. Available from: https:\/\/npcr.se [cited 15.12.2024]"},{"key":"100962","doi-asserted-by":"crossref","unstructured":"Stattin P, Sandin F, Sandb\u00e4ck T, et al. Dashboard report on performance on select quality indicators to cancer care providers. Scand J Urol. 2015;50:1\u20138. https:\/\/doi.org\/10.3109\/21681805.2015.1063083","DOI":"10.3109\/21681805.2015.1063083"},{"key":"100963","unstructured":"The National Prostate Cancer Register of Sweden. Data register for diagnosis and treatment of prostate cancer [Internet]. Available from: www.npcr.se [cited 15.12.2024]"},{"key":"100964","unstructured":"National Prostate Cancer Register of Sweden. RATTEN \u2013 online reporting system [Internet]. Available from: https:\/\/statistik.incanet.se\/npcr\/ [cited 15.12.2024]"},{"key":"100965","doi-asserted-by":"crossref","unstructured":"Tomic K, Berglund A, Robinson D, et al. Capture rate and representativity of The National Prostate Cancer Register of Sweden. Acta Oncol (Madr). 2015;54:158\u2013163. https:\/\/doi.org\/10.3109\/0284186X.2014.939299","DOI":"10.3109\/0284186X.2014.939299"},{"key":"100966","doi-asserted-by":"crossref","unstructured":"Mohler J, Bahnson RR, Boston B, et al. NCCN clinical practice guidelines in oncology: prostate cancer. J Natl Compr Canc Netw. 2010;8:162\u2013200. https:\/\/doi.org\/10.6004\/jnccn.2010.0012","DOI":"10.6004\/jnccn.2010.0010"},{"key":"100967","doi-asserted-by":"crossref","unstructured":"Van Hemelrijck M, Ventimiglia E, Robinson D, et al. Population-based estimates of age and comorbidity specific life expectancy: a first application in Swedish males. BMC Med Inform Decis Mak. 2022;22:35. https:\/\/doi.org\/10.1186\/s12911-022-01766-0","DOI":"10.1186\/s12911-022-01766-0"},{"key":"100968","doi-asserted-by":"crossref","unstructured":"Westerberg M, Irenaeus S, Garmo H, et al. Development and validation of a multi-dimensional diagnosis-based comorbidity index that improves prediction of death in men with prostate cancer: nationwide, population-based register study. PLoS One. 2024;19:e0296804. https:\/\/doi.org\/10.1371\/journal.pone.0296804","DOI":"10.1371\/journal.pone.0296804"},{"key":"100969","doi-asserted-by":"crossref","unstructured":"Westerberg M, Garmo H, Robinson D, et al. Target trial emulation using new comorbidity indices provided risk estimates comparable to a randomized trial. J Clin Epidemiol. 2024;174:111504. https:\/\/doi.org\/10.1016\/j.jclinepi.2024.111504","DOI":"10.1016\/j.jclinepi.2024.111504"},{"key":"100970","doi-asserted-by":"crossref","unstructured":"Gedeborg R, Sund M, Lambe M, et al. An aggregated comorbidity measure based on history of filled drug prescriptions: development and evaluation in two separate cohorts. Epidemiology. 2021;32: 607\u2013615. https:\/\/doi.org\/10.1097\/EDE.0000000000001358","DOI":"10.1097\/EDE.0000000000001358"},{"key":"100971","doi-asserted-by":"crossref","unstructured":"Gedeborg R, Garmo H, Robinson D, et al. Prescription-based prediction of baseline mortality risk among older men. PLoS One. 2020;15:1\u201316. https:\/\/doi.org\/10.1371\/journal.pone.0241439","DOI":"10.1371\/journal.pone.0241439"},{"key":"100972","doi-asserted-by":"crossref","unstructured":"Tomic K, Sandin F, Wigertz A, et al. Evaluation of data quality in the National Prostate Cancer Register of Sweden. Eur J Cancer. 2015;51:101\u2013111. https:\/\/doi.org\/10.1016\/j.ejca.2014.10.025","DOI":"10.1016\/j.ejca.2014.10.025"},{"key":"100973","doi-asserted-by":"crossref","unstructured":"Tanaka T, Suda K, Uyama I. ASO author reflections: chronological or biological age \u2013 which is more important for making clinical decisions in geriatric patients? Ann Surg Oncol. 2019;26:810\u2013811. https:\/\/doi.org\/10.1245\/s10434-019-07994-5","DOI":"10.1245\/s10434-019-07994-5"},{"key":"100974","doi-asserted-by":"crossref","unstructured":"Franck Lissbrant I, Hj\u00e4lm Eriksson M, Lambe M, et al. Set-up and preliminary results from the patient-overview prostate cancer. Longitu-dinal registration of treatment of advanced prostate cancer in the National Prostate Cancer Register of Sweden. Scand J Urol. 2020;54:227\u2013234. https:\/\/doi.org\/10.1080\/21681805.2020.1756402","DOI":"10.1080\/21681805.2020.1756402"},{"key":"100975","doi-asserted-by":"crossref","unstructured":"Hamdy FC, Donovan JL, Lane JA, et al. Fifteen-year outcomes after monitoring, surgery, or radiotherapy for prostate cancer. N Engl J Med. 2023;388:1547\u20131558. https:\/\/doi.org\/10.1056\/NEJMoa2214122","DOI":"10.1016\/j.eururo.2023.08.014"},{"key":"100976","doi-asserted-by":"crossref","unstructured":"Widmark A, Klepp O, Solberg A, et al. Endocrine treatment, with or without radiotherapy, in locally advanced prostate cancer (SPCG-7\/SFUO-3): an open randomised phase III trial. Lancet. 2009;373: 301\u2013308. https:\/\/doi.org\/10.1016\/S0140-6736(08)61815-2","DOI":"10.1016\/S0140-6736(08)61815-2"},{"key":"100977","doi-asserted-by":"crossref","unstructured":"Mason MD, Parulekar WR, Sydes MR, et al. Final report of the intergroup randomized study of combined androgen-deprivation therapy plus radiotherapy versus androgen-deprivation therapy alone in locally advanced prostate cancer. J Clin Oncol. 2015;33:2143\u20132150. https:\/\/doi.org\/10.1200\/JCO.2014.57.7510","DOI":"10.1200\/JCO.2014.57.7510"},{"key":"100978","doi-asserted-by":"crossref","unstructured":"Gonz\u00e1lez Serrano A, Tapia CM, de la Taille A, et al. Adherence to treatment guidelines and associated survival in older patients with prostate cancer: a prospective multicentre cohort study. Cancers (Basel). 2021;13:4694. https:\/\/doi.org\/10.3390\/cancers13184694","DOI":"10.3390\/cancers13184694"},{"key":"100979","doi-asserted-by":"crossref","unstructured":"Steineck G, Bjartell A, Hugosson J, et al. Degree of preservation of the neurovascular bundles during radical prostatectomy and urinary continence 1 year after surgery. Eur Urol. 2015;67:559\u2013568. https:\/\/doi.org\/10.1016\/j.eururo.2014.10.011","DOI":"10.1016\/j.eururo.2014.10.011"},{"key":"100980","doi-asserted-by":"crossref","unstructured":"Baack Kukreja J, Bathala TK, Reichard CA, et al. Impact of preoperative prostate magnetic resonance imaging on the surgical management of high-risk prostate cancer. Prostate Cancer Prostatic Dis. 2020;23:172\u2013178. https:\/\/doi.org\/10.1038\/s41391-019-0171-0","DOI":"10.1038\/s41391-019-0171-0"},{"key":"100981","doi-asserted-by":"crossref","unstructured":"Bratt O, Carlsson S, Fransson P, et al. The Swedish national guidelines on prostate cancer, part 1: early detection, diagnostics, staging, patient support and primary management of non-metastatic disease. Scand J Urol. 2022;56:265\u2013273. https:\/\/doi.org\/10.1080\/21681805.2022.2094462","DOI":"10.1080\/21681805.2022.2094462"},{"key":"100982","doi-asserted-by":"crossref","unstructured":"Grimshaw JM, Russell IT. Effect of clinical guidelines on medical practice: a systematic review of rigorous evaluations. Lancet. 1993;342: 1317\u20131322. https:\/\/doi.org\/10.1016\/0140-6736(93)92244-N","DOI":"10.1016\/0140-6736(93)92244-N"},{"key":"100983","doi-asserted-by":"crossref","unstructured":"G\u00f3mez-Veiga F, Rodr\u00edguez-Antol\u00edn A, Mi\u00f1ana B, et al. Diagnosis and treatment for clinically localized prostate cancer. Adherence to the European Association of Urology clinical guidelines in a nationwide population-based study \u2013 GESCAP group. Actas Urol Esp. 2017;41:359\u2013367. https:\/\/doi.org\/10.1016\/j.acuro.2016.10.009","DOI":"10.1016\/j.acuroe.2017.05.006"},{"key":"100984","doi-asserted-by":"crossref","unstructured":"Dell\u2019Oglio P, Abou-Haidar H, Leyh-Bannurah S-R, et al. Assessment of the rate of adherence to international guidelines for androgen depri-vation therapy with external-beam radiation therapy: a population-based study. Eur Urol. 2016;70:429\u2013435. https:\/\/doi.org\/10.1016\/j.eururo.2016.02.057","DOI":"10.1016\/j.eururo.2016.02.057"},{"key":"100985","doi-asserted-by":"crossref","unstructured":"Hessulf F, Herlitz J, Rawshani A, et al. Adherence to guidelines is associated with improved survival following in-hospital cardiac arrest. Resuscitation. 2020;155:13\u201321. https:\/\/doi.org\/10.1016\/j.resuscitation.2020.07.009","DOI":"10.1016\/j.resuscitation.2020.07.009"},{"key":"100986","doi-asserted-by":"crossref","unstructured":"Ferrannini G, Biber ME, Abdi S, et al. The management of patients with heart failure in Sweden: a survey conducted among physicians in Sweden. Eur Heart J. 2023;44:ehad655.974. https:\/\/doi.org\/10.1093\/eurheartj\/ehad655.974","DOI":"10.1093\/eurheartj\/ehad655.974"},{"key":"100987","doi-asserted-by":"crossref","unstructured":"\u00d6gmundsdottir Michelsen H, Sj\u00f6lin I, Schlyter M, et al. Cardiac rehabilitation after acute myocardial infarction in Sweden \u2013 evaluation of programme characteristics and adherence to European guidelines: the Perfect Cardiac Rehabilitation (Perfect-CR) study. Eur J Prev Cardiol. 2020;27:18\u201327. https:\/\/doi.org\/10.1177\/2047487319865729","DOI":"10.1177\/2047487319865729"},{"key":"100988","doi-asserted-by":"crossref","unstructured":"Herberts P, Malchau H. Long-term registration has improved the quality of hip replacement: a review of the Swedish THR Register com-paring 160,000 cases. Acta Orthop Scand. 2000;71:111\u2013121. https:\/\/doi.org\/10.1080\/000164700317413067","DOI":"10.1080\/000164700317413067"},{"key":"100989","doi-asserted-by":"crossref","unstructured":"MacLennan S, Duncan E, Skolarus TA, et al. Improving guideline adherence in urology. Eur Urol Focus. 2022;8:1545\u20131552. https:\/\/doi.org\/10.1016\/j.euf.2021.10.007","DOI":"10.1016\/j.euf.2021.10.007"},{"key":"100990","doi-asserted-by":"crossref","unstructured":"Demetriou C, Hu L, Smith TO, Hing CB. Hawthorne effect on surgical studies. ANZ J Surg. 2019;89:1567\u20131576. https:\/\/doi.org\/10.1111\/ans.15475","DOI":"10.1111\/ans.15475"},{"key":"100991","doi-asserted-by":"crossref","unstructured":"Brausi M, Hoskin P, Andritsch E, et al. ECCO essential requirements for quality cancer care: prostate cancer. Crit Rev Oncol Hematol. 2020;148:102861. https:\/\/doi.org\/10.1016\/j.critrevonc.2019.102861","DOI":"10.1016\/j.critrevonc.2019.102861"}],"container-title":["Scandinavian Journal of Urology"],"original-title":[],"link":[{"URL":"https:\/\/medicaljournalssweden.se\/SJU\/article\/download\/43107\/49332","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/medicaljournalssweden.se\/SJU\/article\/download\/43107\/49332","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,27]],"date-time":"2025-02-27T12:36:59Z","timestamp":1740659819000},"score":1,"resource":{"primary":{"URL":"https:\/\/medicaljournalssweden.se\/SJU\/article\/view\/43107"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,27]]},"references-count":36,"URL":"https:\/\/doi.org\/10.2340\/sju.v60.43107","relation":{},"ISSN":["2168-1813","2168-1805"],"issn-type":[{"value":"2168-1813","type":"electronic"},{"value":"2168-1805","type":"print"}],"subject":[],"published":{"date-parts":[[2025,2,27]]}}}