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The activities of the Let’s Talk Prostate Cancer (LTPC) Expert Group are funded by Astellas Pharma Inc., Agen Inc and Pfizer Inc, which collectively contribute to and support the objectives of the Expert group.
Astellas Pharma Inc. have full and exclusive editorial control over the LTPC Website

INCIDENCE

There were 34,613 new cases of prostate cancer in Spain in 2020, representing 21.1% of all new male cancers.1 Estimated prostate cancer incidence in Spain is 153.7 per 100,000 population, which is slightly lower than the European average of 153.9 per 100,000.2 Whilst seven out of the 17 regions in Spain have their own recommendations to guide prostate cancer screening, none of the regions has an institutional programme for PSA testing.

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1 The Global Cancer Observatory. Spain. 2020. Accessible at https://gco.iarc.fr/today/data/factsheets/populations/724-spain-fact-sheets.pdf (last accessed March 2022)

2 European Cancer Information System (ECIS). Estimates of cancer incidence and mortality in 2020. Accessible at https://ecis.jrc.ec.europa.eu/explorer.php?$0-0$1-All$2-All$4-1$3-34$6-0,85$5-2008,2008$7-7$CEstByCountry$X0_8-3$X0_19-AE27$X0_20-No$CEstBySexByCountry$X1_8-3$X1_19-AE27$X1_-1-1$CEstByIndiByCountry$X2_8-3$X2_19-AE27$X2_20-No$CEstRelative$X3_8-3$X3_9-AE27$X3_19-AE27$CEstByCountryTable$X4_19-AE27 (last accessed March 2022)

Estimated prostate cancer incidence 2020
(crude rate per 100,000 population)

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European Cancer Information System (ECIS). Estimates of cancer incidence and mortality in 2020. Accessible at https://ecis.jrc.ec.europa.eu/explorer.php?$0-0$1-All$2-All$4-1$3-34$6-0,85$5-2008,2008$7-8$CEstByCountry$X0_8-3$X0_19-AE27$X0_20-No$CEstBySexByCountry$X1_8-3$X1_19-AE27$X1_-1-1$CEstByIndiByCountry$X2_8-3$X2_19-AE27$X2_20-No$CEstRelative$X3_8-3$X3_9-AE27$X3_19-AE27$CEstByCountryTable$X4_19-AE27 (last accessed March 2022)

MORTALITY

In Spain, the estimated mortality rate for prostate cancer is 25.7 per 100,000 population.This is the sixth lowest prostate cancer mortality rate in Europe, after Luxembourg (19.9 per 100,000), Italy (22.9 per 100,000), Malta (24.3 per 100,000), Ireland (24.9 per 100,000) and Romania (25.4 per 100,000).1 The EU average prostate cancer mortality rate is 32.1 per 100,000.1

Links to external websites are provided as a resource to the viewer. We accept no responsibility for the content or services of the linked site other than the information or other materials provided or reviewed by the LTPC expert group members

1 European Cancer Information System (ECIS). Estimates of cancer incidence and mortality in 2020. Accessible at https://ecis.jrc.ec.europa.eu/explorer.php?$0-0$1-All$2-All$4-1$3-34$6-0,85$5-2008,2008$7-8$CEstByCountry$X0_8-3$X0_19-AE27$X0_20-No$CEstBySexByCountry$X1_8-3$X1_19-AE27$X1_-1-1$CEstByIndiByCountry$X2_8-3$X2_19-AE27$X2_20-No$CEstRelative$X3_8-3$X3_9-AE27$X3_19-AE27$CEstByCountryTable$X4_19-AE27 (last accessed February 2022)

Prostate cacner mortality 2020
(crude rate per 100,000 population)

Links to external websites are provided as a resource to the viewer. We accept no responsibility for the content or services of the linked site other than the information or other materials provided or reviewed by the LTPC expert group members

European Cancer Information System (ECIS). Estimates of cancer incidence and mortality in 2020. Accessible at https://ecis.jrc.ec.europa.eu/explorer.php?$0-0$1-All$2-All$4-1$3-34$6-0,85$5-2008,2008$7-8$CEstByCountry$X0_8-3$X0_19-AE27$X0_20-No$CEstBySexByCountry$X1_8-3$X1_19-AE27$X1_-1-1$CEstByIndiByCountry$X2_8-3$X2_19-AE27$X2_20-No$CEstRelative$X3_8-3$X3_9-AE27$X3_19-AE27$CEstByCountryTable$X4_19-AE27 (last accessed March 2022)

SURVIVAL

In Spain, the five-year survival rate for prostate cancer is 89.7% (2010-2014) .1 Five-year survival rates have increased since the late 1990s, although there was a small decrease in five-year survival between 2010-2014 compared with 2005-2009.1

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1 Hofmarcher, T et al. Comparator Report on Cancer in Europe in 2019. IHE Report 2019:7. Accessible at https://www.efpia.eu/publications/cancer-comparator-report/cancer-types/prostate-cancer/ (last accessed March 2022)

Prostate cacner age-standardised 5-year net survival (%)

Links to external websites are provided as a resource to the viewer. We accept no responsibility for the content or services of the linked site other than the information or other materials provided or reviewed by the LTPC expert group members

Hofmarcher, T et al. Comparator Report on Cancer in Europe in 2019. IHE Report 2019:7. Accessible at https://www.efpia.eu/publications/cancer-comparator-report/cancer-types/prostate-cancer/ (last accessed March 2022)

NATIONAL POLICES

In 2021, Spain adopted its new National Cancer Strategy. Prostate cancer is mentioned within the plan. However, the latest recommendations for risk-stratified early detection of prostate cancer, in line with the European Association of Urology guidelines, are not considered yet. It should be noted that each of the 17 autonomous regions in Spain follows its own health service and regional strategy for prostate cancer. Prostate cancer is included in the strategic lines of the cancer plan for Galicia, Comunidad Valenciana and Andalusia.

CLINICAL GUIDELINES

As a federal state, each Spanish region has developed its own clinical guidelines for prostate cancer. The guidelines that provide most comprehensive patients support are set out in Castilla Leon and Andalusia and include patient access to*:

Out of the 17 Spanish regions, the guidelines for only 71 recommend access to a review by a multidisciplinary team, only 42 recommend patient support from a specialist nurse, only 33 recommend that patients should receive a holistic needs assessment, 74 recommend the development of a tailored treatment plan for the patient, 45 support nutrition and exercise advice, 36 recommend that patients should receive psychological support and 57 recommend regular care reviews. To note is that none of the regions include the last EAU recommendations (2019) on a Structured-population based PSA screening for prostate cancer.

2 Castilla Leon, Andalusia, Galicia, Asturias
3 Castilla Leon, Andalusia, Asturias
4 Castilla Leon, Canary Islands, Andalusia, Galicia, Asturias, Catalonia, Murcia
5 Castilla Leon, Andalusia, Asturias, Murcia
6 Castilla Leon, Andalusia, Catalonia
7 Castilla Leon, Andalusia, Galicia, Asturias, Catalonia

CANCER CARE

Access to Specialists

In Spain, there are approximately 11,750 inhabitants per urologist,1 making it one of the countries with the least number of inhabitants per urologist in the EU. Greece has the best ratio, with just 10,000 citizens to every urologist.2

Links to external websites are provided as a resource to the viewer. We accept no responsibility for the content or services of the linked site other than the information or other materials provided or reviewed by the LTPC expert group members

1 European Society of Residents in Urology (ESRU). Spain. March 2018. Accessible at http://esru.eu/?q=spain (last accessed March 2022)
2 European Society of Residents in Urology (ESRU). Greece. March 2018. Accessible at http://esru.eu/?q=greece (last accessed March 2022)

Cost of cancer

The annual direct cost of cancer per person in Spain is €112.1 For comparison, Luxembourg spends the most at €363 per person, while Romania spends the least at €36.1 Whilst a number of factors contribute to improved outcomes for those affected by prostate cancer, studies have shown that those countries that invest more in cancer care tend to achieve better outcomes for patients.1

Links to external websites are provided as a resource to the viewer. We accept no responsibility for the content or services of the linked site other than the information or other materials provided or reviewed by the LTPC expert group members

1 Hofmarcher, T et al. Comparator Report on Cancer in Europe in 2019. IHE Report 2019:7. Accessible at https://www.efpia.eu/publications/cancer-comparator-report/cancer-types/prostate-cancer/ (last accessed March 2022)

Cancer medicines spend

Spain spends €61 per capita on cancer medicines annually, making it the ninth highest spender in the EU.1 At the top end of the scale, Austria spends €108 per capita, while Greece and Estonia spend just €4.1

Links to external websites are provided as a resource to the viewer. We accept no responsibility for the content or services of the linked site other than the information or other materials provided or reviewed by the LTPC expert group members

1 Hofmarcher, T et al. Comparator Report on Cancer in Europe in 2019. IHE Report 2019:7. Accessible at https://www.efpia.eu/publications/cancer-comparator-report/cancer-types/prostate-cancer/ (last accessed March 2022)

Approximate number of inhabitats per urologist - 2018*

Links to external websites are provided as a resource to the viewer. We accept no responsibility for the content or services of the linked site other than the information or other materials provided or reviewed by the LTPC expert group members

*Different data sources were used for Belgium, Hungary, Italy, Romania and the UK, which may use data from different years. See references below. No data was found for Cyprus, Luxembourg, Malta and Slovakia.

European Society of Residents in Urology (ESRU). Countries. March 2018. Accessible at https://esru.eu/?q=countries (last accessed March 2022)
Federal Public Service of Public Health, Safety of the Food Chain and the Environment. HWF STATAN 2019 (detailed statistics). 2019. Accessible at https://organesdeconcertation.sante.belgique.be/fr/documents/hwf-statan-2019-statistiques-detaillees (last accessed March 2022)
Boszormenyi-Nagy, G. Report on urological inpatient care based on 2018 data. Urologia Hungarica. Accessible at http://urologiahungarica.hu/index.php/2020/05/12/beszamolo-az-urologiai-fekvobeteg-ellatasrol-a-2018-as-adatok-alapjan/ (last accessed March 2022)
I.Stat. Personale sanitario. Accessible at http://dati.istat.it/Index.aspx?DataSetCode=DCIS_PERS_SANIT (last accessed March 2022)
Institutul National De Statistica. Activitatea Unitatilor Sanitare in Anul 2019. 2020. Accessible at https://insse.ro/cms/sites/default/files/field/publicatii/activitatea_unitatilor_sanitare_anul_2019.pdf (last accessed March 2022)
United Nations, Population Division, Department of Economic and Social Affairs. World Population Prospects 2019. Accessible at https://population.un.org/wpp/Download/Files/1_Indicators%20(Standard)/EXCEL_FILES/1_Population/
WPP2019_POP_F01_1_TOTAL_POPULATION_BOTH_SEXES.xlsx
(last accessed March 2022)
British Association of Urological Surgeons and The Specialist Advisory Committee in Urology. Workforce Report. 2018. Accessible at https://www.baus.org.uk/_userfiles/pages/files/publications/
Workforce_Report_Sep%202018%20ver%201.1.pdf
(last accessed March 2022)

Direct health cost of cancer per person - 2018 (€)

Links to external websites are provided as a resource to the viewer. We accept no responsibility for the content or services of the linked site other than the information or other materials provided or reviewed by the LTPC expert group members

Hofmarcher, T et al. Comparator Report on Cancer in Europe in 2019. IHE Report 2019:7. Accessible at https://www.efpia.eu/publications/cancer-comparator-report/cancer-types/prostate-cancer/ (last accessed March 2022)

Per capita cost of cancer medicines - 2018 (€)

Links to external websites are provided as a resource to the viewer. We accept no responsibility for the content or services of the linked site other than the information or other materials provided or reviewed by the LTPC expert group members

Hofmarcher, T et al. Comparator Report on Cancer in Europe in 2019. IHE Report 2019:7. Accessible at https://www.efpia.eu/publications/cancer-comparator-report/cancer-types/prostate-cancer/ (last accessed March 2022)

ORGANISATIONS

Patient organisations

The main prostate cancer patient organisation in Spain is:

Prostate Cancer Association (ANCAP)
https://ancap.es/

Reference Number: ONC_2021_0142_BE
Date of preparation: January 2022

Europe Digital Atlas