Norwegian Prostate Cancer Registry

Summary from the annual report 2025

Prostate cancer remains the most common cancer among men in Norway. In 2025, 5350 men were diagnosed,of whom 48 % were under 70 years of age. At the time of diagnosis, 57 % had localized disease, 24 % had regional spread, and 11 % had distant metastases. The number of men living with a prostate cancer diagnosis continues to increase and was close to 68000 in 2025, resulting in agrowing need for long-termfollow-up within the healthcare system. 

Mortality from prostate cancer remains at a low level. In 2025, 876 men died from the disease, the majority of whom were over 80 years of age. Overall mortality has been substantially reduced over recent decades,and there is no evidence of systematic differences in prostatecancer–specific mortality between areas of residence.

The median PSA level at diagnosis has been stable over the past ten years for men under 85 years of age. PSA levels at diagnosis indicate targeted testing aimed at early detection, although local variations suggest some differences in PSA testing practices.The distribution of ISUP grade at diagnosis is largely unchanged compared with previous years; however, challenges remain regarding uniform registration and interpretation of biopsy findings. MRI-based assessment often results in an upgrading of local tumor extent compared with clinical T staging based on digita lrectal examination, influencing risk classification and treatment decisions. From 2025, the intermediate risk group has been divided into favorable and unfavorable intermediate risk in accordance with revised clinical guidelines. 

Primary treatment largely follows the National Guidelines for Prostate Cancer. The proportion of low-risk patients under 75 years receiving radical treatment remains low (5 %). In the high-risk group without distant metastases, more than 80 % of men under 75 years received curative treatment, representing high target achievement. Among men over 75 years of age, treatment choices are more heterogeneous and driven by individual clinical assessments.

Radical prostatectomy and curative radiotherapy continue to constitute the main curative treatment options for localized and locally advanced prostate cancer. Target achievement is high for achieving negative surgical margins in both pT2 and pT3 tumors. Curative radiotherapy is mainly used in patients with intermediate- and high-risk disease, and adherence to recommended combined hormonal therapy in patients with very high risk is high. The use of postoperative radiotherapy has increased over time and is particularly associated with positive surgical margins.

Patient-reported outcomes demonstrate that late adverse effects after treatment are common. Men treated with surgery or radiotherapy report reduced sexual function compared with those who are not treated radically. Urinary incontinence is most pronounced after surgery, while some patients treated with radiotherapy report slightly impaired bowel function. Most patients report satisfaction with the information provided about side effects and the treatment they received.

Overall, the 2025 annual report demonstrates high target achievement for key quality indicators, good adherence to national guidelines, and continued favorable survival outcomes. At the same time, the report highlights persistent variation in diagnostic and treatment practices, particularly among older patients, and an increasing need for knowledge regarding long-term outcomes, late effects, and resource utilization in a growing patient population.