Prostate cancer. National quality report for the year of diagnosis 2012 from the National Prostate Cancer Register (NPCR)

Transkript

1 Landstingens och regionernas nationella samverkansgrupp inom cancersjukvården Prostate cancer National quality report for the year of diagnosis from the National Prostate Cancer Register (NPCR) November

2 Regional cancer centre, Uppsala Örebro University hospital SE-1 UPPSALA 2 Prostate cancer - National quality report,

3 Table of contents Table of contents 1 Foreword Background Number of cases och capture ratio, trends Timeliness Classification of risk categories Waiting times Diagnostics Primary treatment Prostate cancer-specific mortality Publications based on NPCR from the past five years

4 List of Figures List of Tables 1 Number of cases and capture ratio (%) of cases reported to the National Prostate Cancer Register (NPCR) of Sweden by health care region and year, Number of cases and capture ratio (%) in NPCR by county, for year of diagnosis Number of cases (percent) by year of diagnosis and risk category, Main reason for the initiation of the medical investigation that led to the prostate cancer diagnosis by year of diagnosis, Serum PSA-level (µg/l) by year of diagnosis, Number of cores obtained per diagnostic session by year of diagnosis, Number and percentages of men with the primary treatment type registered within six months following diagnosis by health care region and year, Type of radical prostatectomy by year of diagnosis, Type of radical prostatectomy (as primary treatment) year of treatment, -. 3 Type of radical prostatectomy by hospital, Preoperative nerve sparing intent by year of treatment, Preoperative nerve sparing intent by risk category (low, intermediate, and high risk), Pathological T-stage (pt-stage) by year of treatment, Positive surgical margin by year of treatment, Adjuvant therapy following radical prostatectomy by year of treatment, Adjuvant therapy following radical prostatectomy by hospital, Type of radiotherapy by year of diagnosis, Number of men treated with radiotherapy among men having been referred for radiotherapy treatment, Type of radiotherapy by year of treatment, Type of radiotherapy by hospital, Dose per fraction used for external beam radiotherapy of men with low or intermediate risk tumours by hospital, Dose per fraction used for external beam radiotherapy of men with high risk tumours by hospital, Number of men that received postoperative radiotherapy (adjuvant or salvage) by hospital, Number of men with Patient Related Outcome Measures (PROM) data at baseline and one year after treatment (retropubic prostatectomy, robot assisted prostatectomy and external radiotherapy a Type of hormonal treatment for men with M1 and/or PSA µg/l by hospital, b Type of hormonal treatment for men with M1 and/or PSA µg/l by hospital,, cont d a Type of hormonal treatment for men with M/MX and PSA µg/l by hospital, b Type of hormonal treatment for men with M/MX and PSA µg/l by hospital,, cont d List of Figures 1 Age-standardized prostate cancer incidence and mortality per men, Time (months) from diagnosis to reporting to the National Prostate Cancer Register for cases diagnosed Prostate cancer - National quality report,

5 List of Figures 3 Time (months) from diagnosis to reporting to the National Prostate Cancer Register for cases diagnosed by health care region Proportion of men by risk category and year of diagnosis, Proportion of men by risk category and county, Number of days between date of referral and first visit at a specialist clinic by county, MAP - Number of days between date of referral and first visit at a specialist clinic by county, Number of days between date of referral and first visit at a specialist clinic by hospital, Number of days between date of biopsy and date of information to patient by county, MAP - Number of days between date of biopsy and date of information to patient by county, Number of days between date of treatment decision and date of radical prostatectomy by county, MAP - Number of days between date of treatment decision and date of radical prostatectomy by county, Number of days between date of treatment decision and date of radical prostatectomy by hospital, Number of days between date of core biopsies and date of treatment decision in men with metastatic disease (M1 or PSA µg/l) and treatment with non-curative intent by county, MAP - Number of days between date of core biopsies and date of treatment decision in men with metastatic disease (M1 or PSA µg/l) and treatment with non-curative intent by county, Incidence and main reason for initiation of work-up leading to prostate cancer diagnosis by county, Main reason for initiation of work-up leading to prostate cancer diagnosis by hospital, Serum PSA-level (µg/l) at diagnosis by year, Proportion of men years or younger at diagnosis with T1c tumours that underwent or more needle biopsies at diagnostic biopsy session by county, Proportion of men years or younger at diagnosis with T1c tumours that underwent or more needle biopsies at diagnostic biopsy session by hospital, Proportion of men with clinically localized T1-2, PSA less than µg/l and Gleason score or less that underwent bone scintigraphy, by county, 3 and Proportion of men years of younger at diagnosis Gleason score - and/or T3 and/or PSA - µg/l that underwent bone scintigraphy, by county, 3 and Proportion of men older than years at diagnosis Gleason score - and/or T3 and/or PSA - µg/l that underwent bone scintigraphy, by county, 3 and Treatment strategy by risk category and year of diagnosis, Treatment strategy for men years or younger at diagnosis by risk category and year of diagnosis, Treatment strategy for men older than years at diagnosis by risk category and year of diagnosis, Treatment strategy by risk category and age group, Proportion of men years or younger at diagnosis with low risk tumours (T1-2, Gleason score or lower and PSA less than µg/l) that received active surveillance as primary treatment by county,

6 List of Figures 2 Proportion of men years or younger at diagnosis with low risk tumours (T1-2, Gleason score or lower and PSA less than µg/l) that received active surveillance as primary treatment by hospital, Proportion of men older than years at diagnosis with low risk tumours (T1-2, Gleason score or lower and PSA less than µg/l) that received active surveillance as primary treatment by county, Proportion of men older than years at diagnosis with low risk tumours (T1-2, Gleason score or lower and PSA less than µg/l) that received active surveillance as primary treatment by hospital, Proportion of men with very low risk tumours (T1c, Gleason score or lower, PSA less than µg/l, no more than 2 core biopsies with cancer, and total cancer length in core biopsies less than 4 mm) that received active surveillance as primary treatment by county, Proportion of men with very low risk tumours (T1c, Gleason score or lower, PSA less than µg/l, no more than 2 core biopsies with cancer, and total cancer length in core biopsies less than 4 mm) that received active surveillance as primary treatment by hospital, Proportion of men years or younger at diagnosis with intermediate risk tumours that received treatment with curative intent by county, Proportion of men years or younger at diagnosis with intermediate risk tumours that received treatment with curative intent by hospital, Proportion of men older than at diagnosis with intermediate risk tumours that received treatment with curative intent by county, Proportion of men older than at diagnosis with intermediate risk tumours that received treatment with curative intent by hospital, Proportion of men years or younger at diagnosis with high risk tumours that received treatment with curative intent by county, Proportion of men years or younger at diagnosis with high risk tumours that received treatment with curative intent by hospital, Proportion of men older than years at diagnosis with high risk tumours that received treatment with curative intent by county, Proportion of men older than years at diagnosis with high risk tumours that received treatment with curative intent by hospital, Number of radical prostatectomies by hospital and year of treatment, Proportion of men primarily treated with radical prostatectomy that had low risk tumours by hospital, Proportion of men that are missing information on preoperative nerve sparing intent by hospital, Proportion preoperative nerve sparing intent by hospital, Proportion preoperative nerve sparing intent by hospital for low risk category (T1c, Gleason score or lower, PSA less than µg/l), Proportion of men missing information on pathological T-stage by hospital, Proportion pt2 tumours by hospital, Proportion pt2 tumours for preoperative low risk category (T1c, Gleason score or lower, PSA less than µg/l) by hospital, Proportion pt2 tumours for preoperative intermediate risk category by hospital, Proportion pt2 tumours for preoperative localized high risk category by hospital, Proportion of men with unsure or missing information on surgical margin status by hospital, Proportion positive surgical margin by hospital, Proportion positive surgical margin (pt2-tumours) by hospital, Prostate cancer - National quality report,

7 List of Figures Proportion positive surgical margin vs number of surgeries performed, by hospital and type of surgery, Proportion positive surgical margin (pt2-tumours) vs number of surgeries performed, by hospital and type of surgery, Proportion positive surgical margin (intermediate risk tumours) by hospital,... 4 Proportion of men missing information on adjuvant therapy following radical prostatectomy by hospital, Proportion of men with pt3 tumours and/or positive surgical margin that received adjuvant radiotherapy following radical prostatectomy by hospital, Proportion of men with low risk tumors who underwent external radiotherapy that received neoadjuvant hormonal therapy by county, Proportion of men with locally advanced tumours primarily treated with radiotherapy that received treatment with radiation fields that included lymph nodes by county,. 1 2 Proportion of men with locally advanced tumours primarily treated with radiotherapy that received adjuvant hormonal therapy by county, Type of adjuvant hormonal therapy for men with locally advanced tumours primarily treated with radiotherapy by county, Duration of treatment with adjuvant hormonal therapy for men with locally advanced tumours primarily treaded with radiotherapy by county, Proportion of external radiotherapy treatments with IMRT that used gold markers by county, Proportion of men with high risk tumours primarily treated with radiotherapy that received neoadjuvant hormonal therapy with GnRH or TAB by county, Type of treatment for men years or younger at time of diagnosis with locally advanced prostate cancer (T3 or PSA - µg/l, not N1 or M1) by county, Proportion of men years or younger at time of diagnosis with locally advanced prostate cancer (T3 or PSA - µg/l, not N1 or M1) that received neoadjuvant hormonal therapy and radiotherapy by county, Type of treatment for men - years at time of diagnosis with locally advanced prostate cancer (T3 or PSA - µg/l, not N1 or M1) by county, Proportion of men - years at time of diagnosis with locally advanced prostate cancer (T3 or PSA - µg/l, not N1 or M1) that received neoadjuvant hormonal therapy and radiotherapy by county, Type of treatment for men years or younger at time of diagnosis with regionally metastatic prostate cancer (T4 and/or N1 and/or PSA - µg/l) by county, Proportion of men years or younger at time of diagnosis with regionally metastatic prostate cancer (T4 and/or N1 and/or PSA - µg/l) that received neoadjuvant hormonal therapy and radiotherapy by county, Stress urinary incontinence at baseline and one year following treatment according to postal questionnaire Fecal incontinence at baseline and one year following treatment according to postal questionnaire Erectile dysfunction (ED) baseline and one year following treatment according to postal questionnaire Erectile dysfunction (ED) one year following treatment for men with no ED at baseline according to postal questionnaire Median serum PSA level (µg/l) at diagnosis for men with verified distant metastases (M1) by year of diagnosis,

8 List of Figures Cumulative mortality from prostate cancer, cardiovascular disease, and other reasons by risk category and age group, for noncuratively treated men Prostate cancer - National quality report,

9 1 Foreword Each year approximately men are diagnosed with prostate cancer in Sweden. All cases of prostate cancer diagnosed in Sweden are registered in The National Prostate Cancer Register (NPCR) Sweden since in the six health care regions with a capture ratio of more than % compared to The Swedish Cancer Register to which registration is mandatory and regulated by law. NPCR contains data on tumour characteristics and treatment delivered or decided upon up to six months after date of diagnosis. Detailed information on data available in NPCR is found in (1). Since the report for the diagnostic year of that was published in 11 data from each health care provider is reported in NPCR. The data in NPCR is primarily intended to provide a sound basis for quality assurance and bench marking in order to improve care of patients with prostate cancer in Sweden. Data from NPCR are also used for research and a set of linkages between NPCR and other health care registers and demographic databases has been performed in the research project Prostate cancer data Base Sweden (PCBaSe). A full description of these data sets as well as the output from this project was recently published (1). 1. Cohort Profile: The National Prostate Cancer Register (NPCR) of Sweden and Prostate Cancer data Base Sweden (PCBaSe) 2.. M Van Hemelrijck, A Wigertz, F Sandin, H Garmo, K Hellström, P Fransson, A Widmark, M Lambe, J Adolfsson, E Varenhorst, J-E Johansson, P Stattin for NPCR and PCBaSe Sweden. Int J Epidemiol. PMID 2. November, Pär Stattin, Fredrik Sandin, Ola Bratt, Camilla Thellenberg Karlsson, Ingela Frank- Lissbrant, Marie Hjälm-Eriksson and Jan- Erik Damber for the steering group of NPCR. Fredrik Sandin, Regional cancer centre, Uppsala Örebro, performed data management and statistical analysis for this report. Annette Wigertz, Regional cancer centre, Uppsala Örebro, coordinated, edited, and proof read this report.

10 3 Number of cases och capture ratio, trends 2 Background Age standardized incidence/mortality per men 2 1 Incidence Mortality Year Figure 1. Age-standardized prostate cancer incidence and mortality per men, -11. Age-standardized according to the population in Sweden (incidence) or the Nordic countries (mortality) in the year. Source: The National Board of Health and Welfare (incidence), and NORDCAN (mortality), 3 Number of cases och capture ratio, trends Table 1. Number of cases and capture ratio (%) of cases reported to the National Prostate Cancer Register (NPCR) of Sweden by health care region and year, -. Stockholm- Gotland Uppsala- Örebro Southeast South West North Total Year of dx 4 () () 1 () 1 () () 2 () (4) 1 (2) 1 () 1 () 33 () () 3 () 1 () (4) 1 () () () 1 () () 234 () 1 () 1 () () 11 () 1 () () 44 () 2 44 () 1 () 3 () 2 () () 2 () () 3 12 () () () 1 () 1 () 2 () () 4 2 () () 3 () 1 () () () () 3 () () 1 () 14 () () () 31 () () 1 () 1 () 11 () () 2 () 1 () 1 () () () () 11 () () 3 () 111 (3) () 4 () 12 () 12 () 3 () () () () () 1 () 4 () 2 () () () 2 () 3 () 1 () 4 () () 1 () 11 1 (1) () () 1 () () 2 () () 14 (1) 11 () 111 () 1 (1) () () () Total 23 (1) 243 () 1 () 24 () 23 () 2 () 34 () Prostate cancer - National quality report,

11 Table 2. Number of cases and capture ratio (%) in NPCR by county, for year of diagnosis. Cancerregistry NPCR Capture ratio County Dalarna () Gotland 4 4 () Halland () Jönköping 3 3 () Kalmar () Kronoberg 2 2 () Norrbotten () Värmland () Västmanland () Örebro 4 4 () Östergötland 3 3 () Västra Götaland 31 3 () Uppsala () Jämtland 2 1 () Södermanland () Västerbotten 2 2 () Västernorrland 23 () Gävleborg () Blekinge 2 () Stockholm 3 () Övriga/privat 1 (1) Skåne 2 () Since year of diagnosis is taken from the Swedish Cancer Registry, the numbers may differ slightly from the previous table. 11

12 4 Timeliness 4 Timeliness Cumulative proportion (%) reported to NPCR 4 4.%.1%.% Number of months since diagnosis Figure 2. Time (months) from diagnosis to reporting to the National Prostate Cancer Register for cases diagnosed. Cumulative proportion (%) reported to NPCR Cumulative proportion (%) reported to NPCR Cumulative proportion (%) reported to NPCR Stockholm Gotland 1.2%.% % Number of months since diagnosis Southeast.2%.2%.% Number of months since diagnosis West.1%.%.% Number of months since diagnosis Cumulative proportion (%) reported to NPCR Cumulative proportion (%) reported to NPCR Cumulative proportion (%) reported to NPCR Uppsala Örebro.% 2.% 4.% Number of months since diagnosis South.% 4.3% 4 3.4% Number of months since diagnosis North.%.3% 3.% Number of months since diagnosis Figure 3. Time (months) from diagnosis to reporting to the National Prostate Cancer Register for cases diagnosed by health care region. Prostate cancer - National quality report,

13 Classification of risk categories 4. Missing. Distant metastases 4. Regionally metastatic 3b. Locally advanced 3a. Localized high risk 2. Intermediate risk 1c. Low risk (missing) 1b. Low risk (others) 1a. Very low risk 1. Low risk Year Figure 4. Proportion of men by risk category and year of diagnosis, -. Definitions of risk categories, based on clinical evaluation, ie. palpation of the prostate, tumour differentiation according to Gleason in biopsies, and serum PSA level at diagnosis. 1. Low risk T1-2, Gleason score or lower and PSA < µg/l. 1a. Very low risk T1c, PSA < µg/l, Gleaosn score or lower, no more than 2 biopsy cores with cancer, total length of biopsies with cancer < 4mm. 1b. Low risk (others) Low risk that is not categorized to 1a. 1c. Low risk (missing) Missing information for categorization of low risk according 1a/b. 2. Intermediate risk T1-2, Gleason score and/or PSA < µg/l. 3a. Localized high risk T1-2 and Gleason score -. 3b. Locally advanced T3 and/or PSA < µg/l. 4. Regionally metastatic T4 and/or N1 and/or PSA < µg/l, no distant metastases (M or MX).. Distant metastases M1, bone scan shows signs of metastases, and/or PSA µg/l.. Missing Missing information for categorization according to above.

14 Classification of risk categories Definition of preoperative local clinical stage, lymph node status at imaging, and bone metastases at evaluation of skeleton. T1a Not palpable, diagnosed at TUR-P, % of resected chips contained tumour tissue. T1b Not palpable, diagnosed at TUR-P, > % of resected chips contained tumour tissue. T1c Not palpable, diagnosed at biopsy due to eg elevated serum PSA. T2 Palpable, intracapsular ie restricted to the prostate. T3 Palpable, extracapsular ie growth outside of the prostate that may include invasion of seminal vesicles or bladder neck. T4 Palpable invades other structures than seminal vesicles or bladder neck. N1 Regional lymph node metastases. M1 Bone metastases. Others/private Jämtland Kronoberg Kalmar Norrbotten Halland Västmanland Jönköping Västernorrland Västerbotten Skåne Östergötland Västra Götaland Blekinge Gotland Dalarna Örebro Gävleborg Uppsala Värmland Stockholm Södermanland 1a. Very low risk 1b. Low risk (others) 1c. Low risk (missing) 2. Intermediate risk 3a. Localized high risk 3b. Locally advanced 4. Regionally metastatic. Distant metastases. Missing Figure. Proportion of men by risk category and county,. Prostate cancer - National quality report,

15 Table 3. Number of cases (percent) by year of diagnosis and risk category, Low risk 1a. Very low risk 1b. Low risk (others) 1c. Low risk (missing) 2. Intermediate risk 3a. Localized high risk 3b. Locally advanced 4. Regionally metastatic. Distant metastases. Missing Year of dx 44 () (1) 1 (3) 11 (2) () 1 (2) (3) (1) () 23 (3) (2) (11) 1 () (3) (1) 3 () 2 (4) 1 (2) 43 () () (3) 1 3 () 1 () (3) 1 (24) () (1) 2 (3) 2 1 (23) 1 () 2 (3) 14 (23) () 3 (1) (2) 3 (24) 23 (24) 34 (4) 31 () () 1 (1) 4 (2) 4 2 (2) 1 (23) 3 (4) 3 () 1 () 4 () 4 (2) 2 (2) 23 (24) 4 () 1 () () 1 () 2 (2) 24 (2) (2) 4 () 111 () () 111 () 23 (3) 23 (2) 233 (2) 3 (4) (1) 4 () () 2 (2) 24 (2) 2433 (2) 44 () 1 (1) () 3 () 232 (3) 24 (2) 4 () () (2) 33 (3) 4 () 12 (1) () 114 (11) 2 (3) 2 (2) 42 () 11 (1) (1) (3) () 3 (1) 4 () 2 (11) 23 (2) 11 2 (2) () 1 (1) 2 (1) 3 (32) () 1 (1) () 3 (11) 243 (3) 234 (2) 2 () 4 (1) 31 () 2 (31) () 3 (1) 44 () () 244 (3) Definitions of risk categories, based on clinical evaluation, ie. palpation of the prostate, tumour differentiation according to Gleason in biopsies, and serum PSA level at diagnosis. 1. Low risk T1-2, Gleason score or lower and PSA < µg/l. 1b. Low risk (others) Low risk that is not categorized to 1a. 2. Intermediate risk T1-2, Gleason score and/or PSA < µg/l. 3b. Locally advanced T3 and/or PSA < µg/l.. Distant metastases M1, bone scan shows signs of metastases, and/or PSA µg/l. 1a. Very low risk T1c, PSA < µg/l, Gleaosn score or lower, no more than 2 biopsy cores with cancer, total length of biopsies with cancer < 4mm. 1c. Low risk (missing) Missing information for categorization of low risk according 1a/b. 3a. Localized high risk T1-2 and Gleason score Regionally metastatic T4 and/or N1 and/or PSA < µg/l, no distant metastases (M or MX).. Missing Missing information for categorization according to above. 1

16 Waiting times Waiting times Median days Halland Stockholm Västra Götaland Östergötland Uppsala Others/private Skåne Gotland Norrbotten Västernorrland Blekinge Kronoberg Västerbotten Örebro Västmanland Gävleborg Södermanland Jönköping Värmland Dalarna Jämtland Kalmar Median days 4 1 Median and interquartile range (days) Figure. Number of days between date of referral and first visit at a specialist clinic by county,. Information is missing for 3.4 % of the men. Figure. MAP - Number of days between date of referral and first visit at a specialist clinic by county,. 1 Prostate cancer - National quality report,

17 Södra Älvsborgs Sjukhus Borås Södersjukhuset Danderyds sjukhus Hallands sjukhus Kungsbacka Kärnsjukhuset i Skövde Capio S:t Görans sjukhus Urologisektionen Karolinska universitetssjukhuset Huddinge Södra Älvsborgs Sjukhus Skene Sjukhuset i Lidköping Hallands sjukhus Halmstad Löwet specialistmottagning Karolinska universitetssjukhuset Solna Norrtälje sjukhus Varbergs sjukhus Karlskoga lasarett Kalix sjukhus Södertälje sjukhus Skånes universitetssjukhus Malmö Sollefteå sjukhus Vrinnevisjukhuset i Norrköping Gällivare sjukhus Ängelholms sjukhus Akademiska sjukhuset Universitetssjukhuset i Linköping Helsingsborgs lasarett Nyköpings lasarett Private practice Sahlgrenska Universitetssjukhuset Lasarettet i Enköping Lycksele lasarett Specialistsjukvården Falkenberg Visby lasarett Blekingesjukhuset Karlshamn Centrallasarettet Växjö Lasarettet i Ystad Länssjukhuset Ryhov Sjukhuset i Hudiksvall Sjukhuset i Mariestad Sunderby sjukhus Lasarettet i Landskrona Alingsås lasarett Länssjukhuset i Sundsvall Centralsjukhuset Kristianstad Centralsjukhuset i Karlstad Skellefteå lasarett Sjukhuset i Falköping Blekingesjukhuset Karlskrona Kungälvs sjukhus Universitetssjukhuset Örebro Lindesbergs lasarett Norrlands universitetssjukhus Umeå Västmanlands sjukhus Västerås Lasarettet Trelleborg Uddevalla sjukhus Ludvika lasarett Piteå älvdals sjukhus Sjukhuset i Bollnäs Örnsköldsviks sjukhus Kullbergska sjukhuset Sjukhuset i Gävle Mälarsjukhuset Kiruna sjukhus Simrishamns sjukhus Ljungby lasarett Länssjukhuset i Kalmar Sjukhuset i Torsby Höglandssjukhuset Värnamo sjukhus Mora lasarett Östersunds sjukhus Västerviks sjukhus Oskarshamns sjukhus Sjukhuset i Arvika Falu lasarett Median Median and interquartile range (days) Figure. Number of days between date of referral and first visit at a specialist clinic by hospital,. 1

18 Waiting times Median days Blekinge Uppsala Jämtland Kronoberg Örebro Dalarna Skåne Västra Götaland Gotland Halland Others/private Västerbotten Kalmar Norrbotten Västmanland Gävleborg Västernorrland Jönköping Stockholm Södermanland Värmland Östergötland Median days 4 Median and interquartile range (days) Figure. Number of days between date of biopsy and date of information to patient by county,. Information is missing for 3. % of the men. Figure. MAP - Number of days between date of biopsy and date of information to patient by county,. 1 Prostate cancer - National quality report,

19 Median Median Others/private Gävleborg Östergötland Västra Götaland Norrbotten Dalarna Örebro Blekinge Halland Kronoberg Västmanland Västernorrland Södermanland Jämtland Jönköping Västerbotten Stockholm Värmland Skåne Kalmar Uppsala Gotland Median and interquartile range (days) Capio S:t Görans sjukhus UroClinic Carlanderska sjukhuset Vrinnevisjukhuset i Norrköping Uddevalla sjukhus Södra Älvsborgs Sjukhus Borås Danderyds sjukhus Sjukhuset i Gävle Capio Lundby Närsjukhus Sophiahemmet Sahlgrenska Universitetssjukhuset Varbergs sjukhus Sunderby sjukhus Universitetssjukhuset i Linköping Falu lasarett Universitetssjukhuset Örebro Helsingsborgs lasarett Blekingesjukhuset Karlskrona Centrallasarettet Växjö Kärnsjukhuset i Skövde Västmanlands sjukhus Västerås Länssjukhuset i Sundsvall Mälarsjukhuset Karolinska universitetssjukhuset Huddinge Others Östersunds sjukhus Länssjukhuset Ryhov Norrlands universitetssjukhus Umeå Hallands sjukhus Halmstad Capio S:t Görans sjukhus Urologisektionen Centralsjukhuset i Karlstad Karolinska universitetssjukhuset Solna Skånes universitetssjukhus Malmö Länssjukhuset i Kalmar Södersjukhuset Västerviks sjukhus Akademiska sjukhuset Visby lasarett Figure 11. Number of days between date of treatment decision and date of radical prostatectomy by county,. Information is missing for. % of the men. Median and interquartile range (days) Figure. Number of days between date of treatment decision and date of radical prostatectomy by hospital,. Hospitals that contributed less than cases to the figure (Nyköpings lasarett, Höglandssjukhuset, Värnamo sjukhus, Alingsås lasarett, Sjukhuset i Lidköping) have been assigned to Others. days Median days Figure. MAP - Number of days between date of treatment decision and date of radical prostatectomy by county,.

20 Waiting times Median 3 days Uppsala Kronoberg Stockholm Örebro Västra Götaland Gotland Västmanland Halland Skåne Södermanland Blekinge Dalarna Kalmar Västerbotten Jämtland Värmland Västernorrland Norrbotten Gävleborg Others/private Östergötland Jönköping Median days 4 Median and interquartile range (days) Figure. Number of days between date of core biopsies and date of treatment decision in men with metastatic disease (M1 or PSA µg/l) and treatment with non-curative intent by county,. Information is missing for. % of the men. The distribution of non-curative therapy is available in table 2a-2b on pages -. Figure 1. MAP - Number of days between date of core biopsies and date of treatment decision in men with metastatic disease (M1 or PSA µg/l) and treatment with noncurative intent by county,. Prostate cancer - National quality report,

21 Diagnostics Table 4. Main reason for the initiation of the medical investigation that led to the prostate cancer diagnosis by year of diagnosis, 4-. Health control LUTS Other symptoms Missing Total Year of dx 4 2 (2) 342 (3) 3 (32) 42 (4) 24 (2) 4111 (42) 234 (24) () 31 2 (2) 3 (43) (23) 4 () 1 2 (33) 33 (41) () 4 () 3 3 (3) 32 (41) 1 () 333 (4) 44 (42) 3 (3) (1) 324 (3) 411 (42) 34 (3) () (3) (44) 323 (34) () (2) 424 (4) 2 (32) () 23 (3)

22 Diagnostics Inc. 1 Östergötland Kronoberg Halland Västmanland Jämtland Västerbotten Stockholm Västra Götaland Blekinge Skåne Västernorrland Uppsala Kalmar Jönköping Värmland Dalarna Södermanland Gotland Gävleborg Norrbotten Örebro Others/private Health control LUTS Other symptoms Missing Figure 1. Incidence and main reason for initiation of work-up leading to prostate cancer diagnosis by county,. 1 Age-standardized prostate cancer incidence in the corresponding county for the year 11. Ängelholms sjukhus Lindesbergs lasarett Gällivare sjukhus Varbergs sjukhus Lasarettet Trelleborg Kärnsjukhuset i Skövde Höglandssjukhuset Sunderby sjukhus Simrishamns sjukhus Norrtälje sjukhus Others Alingsås lasarett Örnsköldsviks sjukhus Norrlands universitetssjukhus Umeå Specialistsjukvården Falkenberg Södra Älvsborgs Sjukhus Skene Länssjukhuset Ryhov Lasarettet i Landskrona Hallands sjukhus Halmstad Hallands sjukhus Kungsbacka Private practice Värnamo sjukhus Länssjukhuset i Kalmar Centrallasarettet Växjö Västerviks sjukhus Sjukhuset i Lidköping Universitetssjukhuset Örebro Sahlgrenska Universitetssjukhuset Skånes universitetssjukhus Malmö Akademiska sjukhuset Falu lasarett Capio S:t Görans sjukhus Urologisektionen Blekingesjukhuset Karlskrona Universitetssjukhuset i Linköping Danderyds sjukhus Helsingsborgs lasarett Södra Älvsborgs Sjukhus Borås Skellefteå lasarett Lasarettet i Ystad Löwet specialistmottagning Mora lasarett Kalix sjukhus Sjukhuset i Hudiksvall Ljungby lasarett Karolinska universitetssjukhuset Solna Sjukhuset i Mariestad Södertälje sjukhus Sjukhuset i Gävle Södersjukhuset Oskarshamns sjukhus Ludvika lasarett Västmanlands sjukhus Västerås Länssjukhuset i Sundsvall Centralsjukhuset i Karlstad Blekingesjukhuset Karlshamn Sjukhuset i Falköping Sjukhuset i Hässleholm Visby lasarett Nyköpings lasarett Sjukhuset i Torsby Uddevalla sjukhus Kungälvs sjukhus Sjukhuset i Arvika Sollefteå sjukhus Lasarettet i Enköping Vrinnevisjukhuset i Norrköping Centralsjukhuset Kristianstad Kullbergska sjukhuset Karolinska universitetssjukhuset Huddinge Sjukhuset i Bollnäs Lycksele lasarett Mälarsjukhuset Kiruna sjukhus Östersunds sjukhus Karlskoga lasarett Piteå älvdals sjukhus Health control LUTS Other symptoms Missing Figure 1. Main reason for initiation of work-up leading to prostate cancer diagnosis by hospital,. Prostate cancer - National quality report,

23 Table. Serum PSA-level (µg/l) by year of diagnosis, -. Median First quartile Third quartile Missing (%) Total Year of dx (4).1 2 (4) (3) (3) (2) (2) (2) (2) (3) (2) (2).. 23 (2) (2) (2)..3 2 (3) Total (2) PSA < 3 3 PSA<4 4 PSA< PSA< PSA< PSA Missing Figure 1. Serum PSA-level (µg/l) at diagnosis by year, -. 23

24 Diagnostics Table. Number of cores obtained per diagnostic session by year of diagnosis, -. < Missing Total Year of dx 4 () 41 () (23) (1) 3 (11) () 43 (4) 3 (3) (1) () () 32 (3) 1 (4) 2 (2) 1 () 44 () (3) 1 (3) 332 (3) () () 2332 (24) 1 () 34 (4) 3 () 4 () 14 () 3 (2) 34 (4) 1 () The region Stockholm/Gotland is excluded for the year. Södermanland Kronoberg Gotland Blekinge Värmland Västernorrland Västerbotten Jämtland Västmanland Västra Götaland Östergötland Gävleborg Stockholm Skåne Jönköping Others/private Halland Örebro Uppsala Dalarna Norrbotten Kalmar Figure. Proportion of men years or younger at diagnosis with T1c tumours that underwent or more needle biopsies at diagnostic biopsy session by county,. Alingsås lasarett Blekingesjukhuset Karlshamn Blekingesjukhuset Karlskrona Capio S:t Görans sjukhus Urologisektionen Centrallasarettet Växjö Centralsjukhuset i Karlstad Centralsjukhuset Kristianstad Danderyds sjukhus Gällivare sjukhus Hallands sjukhus Halmstad Helsingsborgs lasarett Kalix sjukhus Karolinska universitetssjukhuset Huddinge Kiruna sjukhus Kullbergska sjukhuset Kungälvs sjukhus Kärnsjukhuset i Skövde Lasarettet i Landskrona Lindesbergs lasarett Ljungby lasarett Ludvika lasarett Lycksele lasarett Länssjukhuset i Sundsvall Löwet specialistmottagning Mälarsjukhuset Norrlands universitetssjukhus Umeå Nyköpings lasarett Others Piteå älvdals sjukhus Sjukhuset i Arvika Sjukhuset i Bollnäs Sjukhuset i Falköping Sjukhuset i Gävle Sjukhuset i Hässleholm Sjukhuset i Lidköping Sjukhuset i Mariestad Sjukhuset i Torsby Skellefteå lasarett Sollefteå sjukhus Södertälje sjukhus Södra Älvsborgs Sjukhus Borås Södra Älvsborgs Sjukhus Skene Visby lasarett Värnamo sjukhus Ängelholms sjukhus Örnsköldsviks sjukhus Sahlgrenska Universitetssjukhuset Östersunds sjukhus Västmanlands sjukhus Västerås Universitetssjukhuset i Linköping Vrinnevisjukhuset i Norrköping Västerviks sjukhus Falu lasarett Private practice Skånes universitetssjukhus Malmö Lasarettet i Ystad Höglandssjukhuset Länssjukhuset Ryhov Hallands sjukhus Kungsbacka Simrishamns sjukhus Sjukhuset i Hudiksvall Akademiska sjukhuset Universitetssjukhuset Örebro Oskarshamns sjukhus Södersjukhuset Varbergs sjukhus Uddevalla sjukhus Norrtälje sjukhus Lasarettet Trelleborg Karolinska universitetssjukhuset Solna Karlskoga lasarett Sunderby sjukhus Lasarettet i Enköping Mora lasarett Länssjukhuset i Kalmar Specialistsjukvården Falkenberg Figure. Proportion of men years or younger at diagnosis with T1c tumours that underwent or more needle biopsies at diagnostic biopsy session by hospital,. 24 Prostate cancer - National quality report,

25 Gotland Kalmar Kronoberg Östergötland Jönköping Västmanland Västerbotten Skåne Dalarna Västernorrland Blekinge Others/private Norrbotten Jämtland Halland Västra Götaland Uppsala Stockholm Gävleborg Örebro Värmland Södermanland Örebro Gotland Kalmar Jämtland Västernorrland Kronoberg Värmland Dalarna Jönköping Gävleborg Södermanland Östergötland Uppsala Stockholm Blekinge Västerbotten Skåne Västra Götaland Others/private Västmanland Halland Norrbotten Figure. Proportion of men with clinically localized T1-2, PSA less than µg/l and Gleason score or less that underwent bone scintigraphy, by county, 3 and. Information is missing for.% () and 2.1% (3) of the men, respectively. Figure. Proportion of men years of younger at diagnosis Gleason score - and/or T3 and/or PSA - µg/l that underwent bone scintigraphy, by county, 3 and. Information is missing for.2% () and.% (3) of the men, respectively. Jämtland Kronoberg Västerbotten Jönköping Uppsala Kalmar Värmland Gävleborg Södermanland Örebro Dalarna Västra Götaland Skåne Stockholm Östergötland Blekinge Halland Others/private Västmanland Norrbotten Västernorrland Gotland Figure 23. Proportion of men older than years at diagnosis Gleason score - and/or T3 and/or PSA - µg/l that underwent bone scintigraphy, by county, 3 and. Information is missing for.4% () and.% (3) of the men, respectively. 2

26 Primary treatment Primary treatment Table. Number and percentages of men with the primary treatment type registered within six months following diagnosis by health care region and year, -. Stockholm- Gotland Uppsala- Örebro Southeast South West North Total Year of dx 3 (3) 11 () 4 () 1 (3) 1 () () 41 () 4 (3) 1 () 4 () 1 () 11 () 24 () 3 () 1 () 4 () () 1 () 4 () 23 () 43 () 12 () 23 () () 1 () 4 () 2 () 4 () () 3 () 11 () 1 () () () 31 () 43 (3) 1 () 3 (3) 1 () 12 () () 1 (4) 2 Prostate cancer - National quality report,

27 4 Conservative therapy 4 Conservative therapy 4 Conservative therapy Surgery Surgery Surgery 1. Low risk Radiotherapy 3. High risk Radiotherapy Radiotherapy Hormonal therapy Hormonal therapy. Distant metastases Hormonal therapy Conservative therapy 4 Conservative therapy 2. Intermediate risk Surgery Surgery Radiotherapy Radiotherapy Hormonal therapy 4. Regionally metastatic Hormonal therapy Figure 24. Treatment strategy by risk category and year of diagnosis, Active surveillance Watchful waiting Active surveillance Watchful waiting Active surveillance Watchful waiting Active surveillance Watchful waiting 1a. Very low risk 2. Intermediate risk Surgery Radiotherapy Hormonal therapy Surgery Radiotherapy Hormonal therapy 3a. Localized high risk Surgery Radiotherapy Hormonal therapy 4. Regionally metastatic Surgery Radiotherapy Hormonal therapy Low risk 4 Active surveillance Watchful waiting Surgery Radiotherapy Hormonal therapy 3b. Locally advanced 4 Active surveillance Watchful waiting Surgery Radiotherapy. Distant metastases 4 Active surveillance Watchful waiting Surgery Radiotherapy Hormonal therapy Hormonal therapy Figure 2. Treatment strategy for men years or younger at diagnosis by risk category and year of diagnosis, -. 1a. Very low risk 1. Low risk 1a. Very low risk 1. Low risk < < Active surveillance Watchful waiting Surgery Radiotherapy Hormonal therapy Active surveillance Watchful waiting Surgery Radiotherapy Hormonal therapy Active surveillance Watchful waiting Surgery Radiotherapy Hormonal therapy Active surveillance Watchful waiting Surgery Radiotherapy Hormonal therapy 2. Intermediate risk 2. Intermediate risk < Active surveillance Watchful waiting Surgery Radiotherapy Hormonal therapy Active surveillance Watchful waiting Surgery Radiotherapy Hormonal therapy 3a. Localized high risk 3b. Locally advanced 3a. Localized high risk 3b. Locally advanced < < Active surveillance Watchful waiting Surgery Radiotherapy Hormonal therapy Active surveillance Watchful waiting Surgery Radiotherapy Hormonal therapy Active surveillance Watchful waiting Surgery Radiotherapy Hormonal therapy Active surveillance Watchful waiting Surgery Radiotherapy Hormonal therapy 4. Regionally metastatic. Distant metastases 4. Regionally metastatic. Distant metastases < < Active surveillance Watchful waiting Surgery Radiotherapy Hormonal therapy Active surveillance Watchful waiting Surgery Radiotherapy Hormonal therapy Active surveillance Watchful waiting Surgery Radiotherapy Hormonal therapy Active surveillance Watchful waiting Surgery Radiotherapy Hormonal therapy Figure 2. Treatment strategy for men older than years at diagnosis by risk category and year of diagnosis, -. Figure 2. Treatment strategy by risk category and age group, -. 2

28 Primary treatment Kronoberg Norrbotten Kalmar Others/private Jämtland Uppsala Blekinge Västerbotten Jönköping Östergötland Västra Götaland Halland Dalarna Skåne Västmanland Gävleborg Västernorrland Stockholm Södermanland Örebro Värmland Gotland Figure 2. Proportion of men years or younger at diagnosis with low risk tumours (T1-2, Gleason score or lower and PSA less than µg/l) that received active surveillance as primary treatment by county,. Varbergs sjukhus Danderyds sjukhus Lasarettet i Landskrona Västerviks sjukhus Centrallasarettet Växjö Blekingesjukhuset Karlskrona Lasarettet i Ystad Helsingsborgs lasarett Gällivare sjukhus Mora lasarett Södra Älvsborgs Sjukhus Borås Universitetssjukhuset Örebro Others Private practice Hallands sjukhus Kungsbacka Höglandssjukhuset Östersunds sjukhus Länssjukhuset Ryhov Sunderby sjukhus Akademiska sjukhuset Lycksele lasarett Skellefteå lasarett Sahlgrenska Universitetssjukhuset Universitetssjukhuset i Linköping Norrlands universitetssjukhus Umeå Kärnsjukhuset i Skövde Vrinnevisjukhuset i Norrköping Falu lasarett Södersjukhuset Simrishamns sjukhus Sjukhuset i Gävle Västmanlands sjukhus Västerås Värnamo sjukhus Uddevalla sjukhus Kungälvs sjukhus Skånes universitetssjukhus Malmö Karolinska universitetssjukhuset Huddinge Lasarettet Trelleborg Länssjukhuset i Kalmar Nyköpings lasarett Sjukhuset i Lidköping Sjukhuset i Hudiksvall Ängelholms sjukhus Hallands sjukhus Halmstad Länssjukhuset i Sundsvall Capio S:t Görans sjukhus Urologisektionen Centralsjukhuset i Karlstad Mälarsjukhuset Karolinska universitetssjukhuset Solna Figure 2. Proportion of men years or younger at diagnosis with low risk tumours (T1-2, Gleason score or lower and PSA less than µg/l) that received active surveillance as primary treatment by hospital,. Hospitals that contributed less than cases to the figure (Löwet specialistmottagning, Norrtälje sjukhus, Södertälje sjukhus, Visby lasarett, Karlskoga lasarett, Kullbergska sjukhuset, Lindesbergs lasarett, Ludvika lasarett, Sjukhuset i Arvika, Sjukhuset i Torsby, Oskarshamns sjukhus, Blekingesjukhuset - Karlshamn, Centralsjukhuset Kristianstad, Ljungby lasarett, Alingsås lasarett, Sjukhuset i Falköping, Sjukhuset i Mariestad, Specialistsjukvården Falkenberg, Södra Älvsborgs Sjukhus - Skene, Kalix sjukhus, Kiruna sjukhus, Piteå älvdals sjukhus, Sollefteå sjukhus, Örnsköldsviks sjukhus) have been assigned to Others. 2 Prostate cancer - National quality report,

29 Kronoberg Others/private Norrbotten Västerbotten Halland Jönköping Västernorrland Jämtland Södermanland Västmanland Örebro Skåne Blekinge Uppsala Östergötland Västra Götaland Stockholm Kalmar Dalarna Gävleborg Värmland Gotland Figure 3. Proportion of men older than years at diagnosis with low risk tumours (T1-2, Gleason score or lower and PSA less than µg/l) that received active surveillance as primary treatment by county,. Gällivare sjukhus Karlskoga lasarett Lindesbergs lasarett Sjukhuset i Falköping Lycksele lasarett Lasarettet i Ystad Simrishamns sjukhus Södertälje sjukhus Varbergs sjukhus Västerviks sjukhus Ängelholms sjukhus Danderyds sjukhus Sjukhuset i Hudiksvall Centrallasarettet Växjö Hallands sjukhus Kungsbacka Skellefteå lasarett Private practice Södra Älvsborgs Sjukhus Skene Blekingesjukhuset Karlskrona Höglandssjukhuset Länssjukhuset i Kalmar Sunderby sjukhus Värnamo sjukhus Örnsköldsviks sjukhus Länssjukhuset Ryhov Östersunds sjukhus Ljungby lasarett Västmanlands sjukhus Västerås Vrinnevisjukhuset i Norrköping Sahlgrenska Universitetssjukhuset Akademiska sjukhuset Mora lasarett Norrlands universitetssjukhus Umeå Länssjukhuset i Sundsvall Uddevalla sjukhus Capio S:t Görans sjukhus Urologisektionen Helsingsborgs lasarett Others Skånes universitetssjukhus Malmö Universitetssjukhuset i Linköping Hallands sjukhus Halmstad Alingsås lasarett Lasarettet i Landskrona Södersjukhuset Ludvika lasarett Nyköpings lasarett Lasarettet Trelleborg Falu lasarett Universitetssjukhuset Örebro Sjukhuset i Gävle Karolinska universitetssjukhuset Huddinge Centralsjukhuset i Karlstad Karolinska universitetssjukhuset Solna Sjukhuset i Lidköping Kärnsjukhuset i Skövde Kungälvs sjukhus Norrtälje sjukhus Figure 31. Proportion of men older than years at diagnosis with low risk tumours (T1-2, Gleason score or lower and PSA less than µg/l) that received active surveillance as primary treatment by hospital,. Hospitals that contributed less than cases to the figure (Löwet specialistmottagning, Visby lasarett, Kullbergska sjukhuset, Mälarsjukhuset, Sjukhuset i Arvika, Sjukhuset i Bollnäs, Oskarshamns sjukhus, Blekingesjukhuset - Karlshamn, Centralsjukhuset Kristianstad, Sjukhuset i Hässleholm, Sjukhuset i Mariestad, Specialistsjukvården Falkenberg, Södra Älvsborgs Sjukhus - Borås, Kiruna sjukhus, Sollefteå sjukhus) have been assigned to Others. 2

30 Primary treatment Norrbotten Västernorrland Gävleborg Örebro Uppsala Kronoberg Östergötland Others/private Västerbotten Halland Dalarna Kalmar Västra Götaland Skåne Jönköping Blekinge Västmanland Jämtland Stockholm Värmland Södermanland Gotland Figure 32. Proportion of men with very low risk tumours (T1c, Gleason score or lower, PSA less than µg/l, no more than 2 core biopsies with cancer, and total cancer length in core biopsies less than 4 mm) that received active surveillance as primary treatment by county,. Gällivare sjukhus Lycksele lasarett Länssjukhuset i Sundsvall Sjukhuset i Hudiksvall Sunderby sjukhus Danderyds sjukhus Hallands sjukhus Kungsbacka Uddevalla sjukhus Centrallasarettet Växjö Falu lasarett Södertälje sjukhus Västerviks sjukhus Ängelholms sjukhus Varbergs sjukhus Akademiska sjukhuset Södra Älvsborgs Sjukhus Borås Vrinnevisjukhuset i Norrköping Simrishamns sjukhus Universitetssjukhuset Örebro Private practice Sahlgrenska Universitetssjukhuset Höglandssjukhuset Universitetssjukhuset i Linköping Skellefteå lasarett Kärnsjukhuset i Skövde Oskarshamns sjukhus Helsingsborgs lasarett Länssjukhuset Ryhov Others Norrlands universitetssjukhus Umeå Västmanlands sjukhus Västerås Östersunds sjukhus Skånes universitetssjukhus Malmö Lasarettet i Ystad Mora lasarett Länssjukhuset i Kalmar Centralsjukhuset i Karlstad Karolinska universitetssjukhuset Huddinge Capio S:t Görans sjukhus Urologisektionen Södersjukhuset Hallands sjukhus Halmstad Mälarsjukhuset Södra Älvsborgs Sjukhus Skene Värnamo sjukhus Kungälvs sjukhus Karolinska universitetssjukhuset Solna Sjukhuset i Lidköping Figure 33. Proportion of men with very low risk tumours (T1c, Gleason score or lower, PSA less than µg/l, no more than 2 core biopsies with cancer, and total cancer length in core biopsies less than 4 mm) that received active surveillance as primary treatment by hospital,. Hospitals that contributed less than cases to the figure (Löwet specialistmottagning, Visby lasarett, Karlskoga lasarett, Lindesbergs lasarett, Ludvika lasarett, Nyköpings lasarett, Sjukhuset i Arvika, Sjukhuset i Gävle, Blekingesjukhuset - Karlshamn, Blekingesjukhuset - Karlskrona, Centralsjukhuset Kristianstad, Lasarettet i Landskrona, Lasarettet Trelleborg, Ljungby lasarett, Sjukhuset i Hässleholm, Sjukhuset i Falköping, Sjukhuset i Mariestad, Specialistsjukvården Falkenberg, Kiruna sjukhus, Piteå älvdals sjukhus, Sollefteå sjukhus, Örnsköldsviks sjukhus) have been assigned to Others. 3 Prostate cancer - National quality report,

31 Jämtland Blekinge Dalarna Värmland Västernorrland Stockholm Uppsala Västerbotten Södermanland Skåne Halland Västmanland Kronoberg Örebro Västra Götaland Östergötland Kalmar Jönköping Gävleborg Gotland Others/private Norrbotten Figure 34. Proportion of men years or younger at diagnosis with intermediate risk tumours that received treatment with curative intent by county,. Blekingesjukhuset Karlshamn Karolinska universitetssjukhuset Solna Östersunds sjukhus Nyköpings lasarett Länssjukhuset i Kalmar Falu lasarett Örnsköldsviks sjukhus Blekingesjukhuset Karlskrona Capio S:t Görans sjukhus Urologisektionen Specialistsjukvården Falkenberg Centralsjukhuset i Karlstad Hallands sjukhus Halmstad Sjukhuset i Arvika Norrlands universitetssjukhus Umeå Länssjukhuset i Sundsvall Skellefteå lasarett Akademiska sjukhuset Skånes universitetssjukhus Malmö Kärnsjukhuset i Skövde Lindesbergs lasarett Mora lasarett Helsingsborgs lasarett Sahlgrenska Universitetssjukhuset Lasarettet i Landskrona Ängelholms sjukhus Värnamo sjukhus Centrallasarettet Växjö Södersjukhuset Universitetssjukhuset i Linköping Sjukhuset i Gävle Västmanlands sjukhus Västerås Karolinska universitetssjukhuset Huddinge Universitetssjukhuset Örebro Södra Älvsborgs Sjukhus Borås Kullbergska sjukhuset Lycksele lasarett Länssjukhuset Ryhov Mälarsjukhuset Lasarettet i Ystad Hallands sjukhus Kungsbacka Vrinnevisjukhuset i Norrköping Höglandssjukhuset Oskarshamns sjukhus Varbergs sjukhus Visby lasarett Gällivare sjukhus Uddevalla sjukhus Private practice Ljungby lasarett Simrishamns sjukhus Alingsås lasarett Västerviks sjukhus Others Sjukhuset i Lidköping Lasarettet Trelleborg Sjukhuset i Hudiksvall Danderyds sjukhus Sunderby sjukhus Södertälje sjukhus Piteå älvdals sjukhus Löwet specialistmottagning Figure 3. Proportion of men years or younger at diagnosis with intermediate risk tumours that received treatment with curative intent by hospital,. Hospitals that contributed less than cases to the figure (Norrtälje sjukhus, Karlskoga lasarett, Lasarettet i Enköping, Ludvika lasarett, Sjukhuset i Bollnäs, Sjukhuset i Torsby, Centralsjukhuset Kristianstad, Kungälvs sjukhus, Sjukhuset i Falköping, Sjukhuset i Mariestad, Kalix sjukhus, Kiruna sjukhus) have been assigned to Others. 31