Prostate cancer (PC) primarily affects elderly men. However, the specific features of cases
diagnosed at younger ages (<65 years) suggest that they may represent a different clinical
subtype. Our aim was to assess this suggestion by contrasting the geographical PC mortality
and hospital admissions patterns in Spain for all ages to those in younger men. A total of 29,566 PC deaths (6% among those <65 years) were registered between 2010–
2014, with three high-mortality risk zones: Northwest Spain; Southwest Andalusia & Granada;
and a broad band extending from the Pyrenees Mountains to the north of Valencia. In
younger men, the spatial patterns shared the high risk of mortality in the Northwest but not
the central band. The PC hospital discharge rates confirmed a North-South gradient but
also low mortality/high admission rates in Madrid and Barcelona and the opposite in Southwest
Andalusia. The consistent high PC mortality/morbidity risk in the Northwest of Spain indicates an area
with a real excess of risk. The different spatial pattern in younger men suggests that some
factors associated with geographical risk might have differential effects by age. Finally, the
regional divergences in mortality and morbidity hint at clinical variability as a source of inequity
within Spain.The study was supported by research
grants from the Spanish Health Research Fund
ISCIII cofunded by FEDER funds -a way to build
Europe (http://www.isciii.es/): PFN: FIS PI11/
00871, BPG: FIS PI12/00150, PI17CIII/00034,
GLA: PI14CIII/00050, JJJM: PI15/00914; Joint
Action InfAct (European Commission): BPG: HPJA-
06-2017, PFN: HP-JA-06-2017