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Voice Off: Prostate Cancer Statistics, a Gapminder video with Hans Rosling.
Hans Rosling: Prostate cancer is most frequently reported from the United States of America.
The size of the bubbles on this graph represent the number of men diagnosed with this cancer.
You can also see that it is common in West Europe.
To show you the risk of getting diagnosed I have to move to another type of shot. Here the bubbles
are still the countries and the size is the number of men diagnosed. The vertical axis
here shows the number getting prostate cancer diagnosis per 100,000 men and the horizontal
axis is income per person. There is no direct relation between risk of
prostate cancer and income. And beware, here there is made the standardization for the
age composition. So the rates of the different countries are compared to as if the age composition
were the same in all countries. And look here! In Japan, the risk of getting
prostate cancer is much lower than it is in Australia, which has the same income.
And the reason for that is that as far as research goes, the two major known causes for prostate cancer in
men are high age and ethnic genetic background. There is a higher risk for this disease in
men with Caucasian, European and North American origin and in men with African origin than
it is for other population groups in the world.
And there is another aspect also, and that is that this cancer exists in an aggressive
form that requires immediate treatment but also in more modest forms of cancer that are not
really causing problems for the patient. It is difficult to know when to put the diagnosis
and when to give the treatment. The high rates in the United States are maybe due to some overdiagnosis.
Look at this graph. Here, I said, on this axis I still have the number of men getting
prostate cancer diagnosis by 100,000
and I have on this axis the number of men dying from this disease.
The size of the bubbles now correspond to the population size. The United States have
a very higher risk of getting the diagnosis of prostate cancer. Whereas the risk of dying
is not so high. And this is what supports the hypothesis that there is some overdiagnosing.
Now, let me compare my own country Sweden. Here we have data for Sweden and some few
other countries for many years. In 1958, in Sweden, there was a risk of 27 in 100,000
to get the diagnosis and 16 in 100,000 to die. That's about half of the men with this
diagnosis die. Now what has happened is that this is the
change where we have annual statistics for prostate cancer. Today in Sweden, the risk
of dying is about 20 per 100,000 whereas the risk of getting the diagnosis is 91.
Sweden has a similar development to the United States. There may also be some overdiagnosis
in Sweden or it may be wise to overdiagnose this cancer. The researchers are standing
at this point today. What we know is that it is extremely useful
to have good cancer statistics for many countries so that we can compare and learn from each
other. And that actually doesn't exist not even for all rich countries.
And the world is facing more and more cancer so my personal view is that more resources
should be put into collection and compilation of good cancer statistics.