Impact of PSA testing and prostatic biopsy on cancer incidence and mortality: comparative study between the Republic of Ireland and Northern Ireland

Objectives: To investigate the impact of different PSA testing policies and health-care systems on prostate cancer incidence and mortality in two countries with similar populations, the Republic of Ireland (RoI) and Northern Ireland (NI).

Methods: Population-level data on PSA tests, prostate biopsies and prostate cancer cases 1993–2005 and prostate cancer deaths 1979–2006 were compiled. Annual percentage change (APC) was estimated by joinpoint regression.

Results: Prostate cancer rates were similar in both areas in 1994 but increased rapidly in RoI compared to NI. The PSA testing rate increased sharply in RoI (APC = +23.3%), and to a lesser degree in NI (APC = +9.7%) to reach 412 and 177 tests per 1,000 men in 2004, respectively. Prostatic biopsy rates rose in both countries, but were twofold higher in RoI. Cancer incidence rates rose significantly, mirroring biopsy trends, in both countries reaching 440 per 100,000 men in RoI in 2004 compared to 294 in NI. Median age at diagnosis was lower in RoI (71 years) compared to NI (73 years) (p < 0.01) and decreased significantly over time in both countries. Mortality rates declined from 1995 in both countries (APC = -1.5% in RoI, -1.3% in NI) at a time when PSA testing was not widespread.

Conclusions: Prostatic biopsy rates, rather than PSA testing per se, were the main driver of prostate cancer incidence. Because mortality decreases started before screening became widespread in RoI, and mortality remained low in NI, PSA testing is unlikely to be the explanation for declining mortality.

The Liedertheater of Wenzel and Mensching: Subversive Use of the Agitprop and Clowning Tradition in the GDR

The East German poet-clowns Hans-Eckardt Wenzel and Steffen Mensching rose to prominence during the GDR's (German Democratic Republic; Deutsche Demokratische Republik, DDR) Peaceful Revolution of autumn 1989 with their cabaret production Letztes aus der Da Da eR. A film adaptation of the production was made by Jörg Foth in 1990, which was finally released on DVD with English subtitles in the United Kingdom and North America in 2009 (Latest from the Da-Da-R). In light of this long-overdue interest in Wenzel & Mensching, this article will attempt to put the work of the duo in historical and aesthetic context. Their use of character, masks, music, and philosophy combined to create the distinctly grotesque world that constituted their Liedertheater performances.