Periodic trends in geographical variation of prostate cancer incidence and mortality in Finland between 1985 and 2019

Figures & data

Table 1. Average population count, number (N) of PCa cases and deaths and age-standardized incidence and mortality rate by calendar period, university hospital region and municipality urbanization, education, and income level.

	Population count	PCa cases		PCa deaths
		N	Rate^a	N	Rate^a
Period
1985–1989	2,389,775	6415	105.7	2752	49.5
1990–1994	2,448,786	8774	131.9	3332	53.5
1995–1999	2,503,962	14,359	188.7	3787	54.4
2000–2004	2,541,460	20,583	231.0	3905	49.3
2005–2009	2,591,621	23,082	220.2	3982	42.0
2010–2014	2,659,280	24,086	200.5	4289	37.6
2015–2019	2,713,260	25,886	190.8	4567	33.7
University Hospital region
Helsinki	933,046	42,296	193.8	8247	42.3
Turku	413,445	22,031	186.8	5488	48.5
Tampere	417,450	24,522	211.8	4839	44.6
Kuopio	407,638	17,937	155.5	4314	39.9
Oulu	365,089	15,382	170.5	3471	42.3
Åland	13,067	1017	259.6	255	65.4
Municipality urbanization
Urban	1,705,174	77,292	191.3	15,531	42.5
Semi-urban	433,088	22,685	185.1	5251	45.8
Rural	411,474	23,208	171.0	5832	44.4
Municipality education
Lowest tertile	937,361	50,566	179.7	12,031	45.3
Middle tertile	818,986	38,624	190.0	7956	42.8
Highest tertile	793,387	33,995	191.7	6627	41.6
Municipality income
Lowest tertile	883,601	46,350	179.5	10,576	43.3
Middle tertile	892909	43,645	183.8	9762	44.3
Highest tertile	773,225	33,190	199.3	6276	43.0

^aPer 100,000 person-years and age-standardized to the male population of Finland in 2015–2019.

Figure 1. Age-standardized PCa incidence (blue) and mortality (violet) per 100,000 person-years in 5-years period from 1985–1989 to 2015–2019 by hospital district (circle) and municipality (dot).

Figure 2. Age-standardized PCa incidence (blue) and mortality (violet) per 100,000 person-years in 5-years period from 1985–1989 to 2015–2019 by age group (0–69 years with dashed and 70+ years with solid line for the average rate), hospital district (circle), and municipality (dot).

Table 2. SD of age-standardized PCa incidence and mortality (per 100,000 person-years) between hospital districts (Between), within hospital districts (Within), and between all municipalities (Total) by calendar period.

	Between	95% CI	Within	95% CI	Total	95% CI	W/T	95% CI
Incidence
1985–1989	18.6	(14.8, 22.8)	12.9	(3.6, 18.0)	22.2	(17.1, 27.8)	0.33	(0.04, 0.50)
1990–1994	17.5	(12.3, 24.2)	19.0	(14.6, 24.4)	24.4	(18.4, 31.7)	0.54	(0.39, 0.69)
1995–1999	29.0	(25.9, 32.4)	30.7	(25.7, 35.9)	37.9	(33.5, 42.6)	0.53	(0.42, 0.62)
2000–2004	50.3	(44.7, 57.4)	29.4	(23.7, 35.5)	56.5	(49.8, 64.5)	0.26	(0.18, 0.34)
2005–2009	41.2	(35.8, 48.1)	29.6	(24.5, 35.2)	49.1	(42.6, 56.9)	0.34	(0.25, 0.43)
2010–2014	28.0	(23.5, 33.5)	29.1	(24.5, 33.9)	40.6	(35.0, 46.9)	0.52	(0.41, 0.62)
2015–2019	27.0	(21.4, 33.3)	20.4	(14.8, 25.3)	31.1	(26.0, 36.8)	0.36	(0.23, 0.49)
Mortality
1985–1989	5.9	(3.6, 8.6)	4.8	(2.4, 7.6)	7.5	(4.7, 10.6)	0.40	(0.16, 0.63)
1990–1994	6.8	(4.2, 9.9)	6.0	(3.6, 9.1)	8.8	(5.7, 12.5)	0.44	(0.26, 0.62)
1995–1999	6.1	(3.5, 9.0)	6.6	(4.1, 9.4)	8.6	(5.5, 11.9)	0.54	(0.34, 0.74)
2000–2004	6.7	(3.8, 10.5)	5.5	(3.3, 8.2)	8.4	(5.0, 12.8)	0.40	(0.23, 0.62)
2005–2009	7.0	(4.9, 10.1)	6.8	(4.6, 9.2)	9.0	(6.6, 11.8)	0.48	(0.32, 0.67)
2010–2014	2.4	(1.0, 4.4)	4.6	(1.5, 7.4)	4.8	(1.7, 7.5)	0.76	(0.44, 0.91)
2015–2019	1.6	(0.5, 3.5)	2.0	(0.7, 4.3)	2.4	(0.9, 4.8)	0.60	(0.19, 0.86)

Proportion of variation within hospital districts out of the total variation between municipalities (W/T) is also shown.

Table 3. Age adjusted rate ratios of level of municipality urbanization, education and income in PCa incidence, and mortality by calendar period.

(A) Based on univariate model
	Incidence (95%CI)			Mortality (95%CI)
Urbanization	Rural	Semi-urban	Urban	Rural	Semi-urban	Urban
1985–1989	1	1.11 (1.01, 1.21)	1.10 (1.02, 1.18)	1	1.08 (0.96, 1.21)	1.09 (0.97, 1.21)
1990–1994	1	1.09 (1.02, 1.18)	1.13 (1.06, 1.21)	1	1.09 (0.98, 1.22)	1.08 (0.98, 1.19)
1995–1999	1	1.05 (0.98, 1.13)	1.09 (1.02, 1.16)	1	1.11 (1.00, 1.23)	1.09 (1.00, 1.19)
2000–2004	1	1.01 (0.95, 1.07)	1.02 (0.97, 1.08)	1	1.04 (0.94, 1.15)	0.97 (0.88, 1.06)
2005–2009	1	1.05 (0.99, 1.11)	1.05 (1.00, 1.11)	1	0.92 (0.83, 1.02)	0.90 (0.82, 0.98)
2010–2014	1	1.04 (0.98, 1.10)	1.04 (0.98, 1.09)	1	0.92 (0.83, 1.02)	0.87 (0.80, 0.95)
2015–2019	1	1.00 (0.95, 1.06)	1.01 (0.97, 1.06)	1	1.03 (0.93, 1.13)	0.94 (0.87, 1.02)
Education	Low	Middle	High	Low	Middle	High
1985–1989	1	1.10 (1.02, 1.19)	1.05 (0.97, 1.15)	1	1.06 (0.95, 1.18)	1.06 (0.95, 1.17)
1990–1994	1	1.03 (0.95, 1.11)	1.15 (1.06, 1.24)	1	1.04 (0.94, 1.14)	1.01 (0.92, 1.11)
1995–1999	1	1.02 (0.95, 1.09)	1.13 (1.05, 1.22)	1	1.05 (0.95, 1.15)	0.99 (0.89, 1.09)
2000–2004	1	1.01 (0.96, 1.07)	1.05 (0.99, 1.12)	1	0.99 (0.90, 1.08)	0.91 (0.83, 1.00)
2005–2009	1	1.03 (0.97, 1.09)	1.01 (0.95, 1.08)	1	0.87 (0.79, 0.97)	0.89 (0.80, 0.99)
2010–2014	1	1.01 (0.95, 1.07)	1.00 (0.94, 1.07)	1	0.88 (0.81, 0.96)	0.89 (0.82, 0.98)
2015–2019	1	1.00 (0.95, 1.05)	1.01 (0.95, 1.06)	1	0.96 (0.88, 1.03)	0.89 (0.83, 0.96)
Income	Low	Middle	High	Low	Middle	High
1985–1989	1	1.05 (0.97, 1.14)	1.06 (0.93, 1.19)	1	1.12 (1.02, 1.23)	1.14 (1.00, 1.30)
1990–1994	1	1.05 (0.97, 1.12)	1.08 (0.97, 1.20)	1	1.01 (0.92, 1.10)	1.04 (0.91, 1.20)
1995–1999	1	1.02 (0.95, 1.09)	1.07 (0.96, 1.19)	1	1.05 (0.97, 1.15)	1.01 (0.88, 1.14)
2000–2004	1	1.02 (0.97, 1.08)	1.01 (0.93, 1.10)	1	1.07 (0.99, 1.16)	1.02 (0.89, 1.15)
2005–2009	1	1.00 (0.95, 1.06)	1.00 (0.91, 1.08)	1	0.95 (0.87, 1.04)	0.89 (0.76, 1.03)
2010–2014	1	1.04 (0.98, 1.10)	0.97 (0.89, 1.06)	1	1.00 (0.92, 1.09)	0.94 (0.84, 1.06)
2015–2019	1	1.00 (0.95, 1.04)	1.00 (0.94, 1.08)	1	0.99 (0.92, 1.06)	0.98 (0.89, 1.09)
(B) Based on multivariate model
	Incidence (95%CI)			Mortality (95%CI)
Urbanization	Rural	Semi-urban	Urban	Rural	Semi-urban	Urban
1985–1989	1	1.09 (1.00, 1.18)	1.04 (0.94, 1.15)	1	1.06 (0.93, 1.20)	1.05 (0.92, 1.21)
1990–1994	1	1.09 (1.00, 1.18)	1.09 (0.99, 1.21)	1	1.10 (0.98, 1.23)	1.11 (0.97, 1.27)
1995–1999	1	1.04 (0.97, 1.12)	1.05 (0.96, 1.15)	1	1.11 (0.99, 1.24)	1.12 (0.98, 1.26)
2000–2004	1	1.00 (0.94, 1.06)	1.00 (0.93, 1.07)	1	1.04 (0.93, 1.15)	0.99 (0.88, 1.11)
2005–2009	1	1.05 (0.99, 1.11)	1.06 (0.98, 1.13)	1	0.95 (0.85, 1.06)	0.98 (0.86, 1.10)
2010–2014	1	1.04 (0.98, 1.11)	1.04 (0.96, 1.11)	1	0.94 (0.85, 1.03)	0.93 (0.83, 1.04)
2015–2019	1	1.01 (0.96, 1.06)	1.02 (0.96, 1.08)	1	1.05 (0.95, 1.16)	1.01 (0.91, 1.12)
Education	Low	Middle	High	Low	Middle	High
1985–1989	1	1.08 (0.98, 1.18)	1.04 (0.93, 1.16)	1	1.03 (0.89, 1.15)	1.03 (0.90, 1.18)
1990–1994	1	0.99 (0.90, 1.08)	1.09 (0.97, 1.22)	1	0.99 (0.88, 1.11)	0.96 (0.82, 1.11)
1995–1999	1	0.99 (0.91, 1.08)	1.09 (0.98, 1.21)	1	0.99 (0.89, 1.11)	0.93 (0.81, 1.06)
2000–2004	1	1.01 (0.94, 1.09)	1.05 (0.97, 1.14)	1	0.98 (0.88, 1.09)	0.92 (0.82, 1.05)
2005–2009	1	1.01 (0.94, 1.07)	0.98 (0.90, 1.08)	1	0.89 (0.79, 1.00)	0.91 (0.79, 1.06)
2010–2014	1	0.99 (0.93, 1.06)	0.99 (0.91, 1.08)	1	0.91 (0.82, 1.01)	0.94 (0.83, 1.05)
2015–2019	1	0.99 (0.94, 1.05)	1.00 (0.92, 1.07)	1	0.96 (0.87, 1.05)	0.90 (0.81, 0.99)
Income	Low	Middle	High	Low	Middle	High
1985–1989	1	1.02 (0.95, 1.10)	1.01 (0.89, 1.14)	1	1.10 (1.00, 1.21)	1.12 (0.97, 1.29)
1990–1994	1	1.02 (0.95, 1.10)	1.04 (0.92, 1.16)	1	0.99 (0.91, 1.08)	1.03 (0.89, 1.19)
1995–1999	1	1.00 (0.93, 1.07)	1.03 (0.93, 1.15)	1	1.04 (0.95, 1.13)	1.01 (0.87, 1.16)
2000–2004	1	1.02 (0.96, 1.07)	0.99 (0.90, 1.09)	1	1.07 (0.98, 1.17)	1.04 (0.90, 1.18)
2005–2009	1	0.99 (0.93, 1.04)	0.99 (0.90, 1.08)	1	0.97 (0.89, 1.07)	0.93 (0.79, 1.08)
2010–2014	1	1.04 (0.97, 1.09)	0.97 (0.88, 1.06)	1	1.03 (0.95, 1.12)	0.99 (0.89, 1.11)
2015–2019	1	1.00 (0.95, 1.05)	1.00 (0.93, 1.09)	1	0.99 (0.92, 1.07)	1.01 (0.91, 1.13)

CI: confidence interval.

Values with significance are bolded.

Data availability statement

The data that support the findings of this study are available from the corresponding author, [HS], upon reasonable request.