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Estimates of cancer incidence and mortality in France as well as survival data are published by the cancer registry network (Francim). In 2000, the number of new cancer cases was almost 280,000 in France. This number has been gradually increasing, partly due to population aging. The proportion of urological cancers is increasing as well, as a consequence of the marked increase in number of prostate cancers. The estimated number of new cases for the 4 main urological cancers in 2000 reached 61,174, distributed as follows: 40,310 prostate cancers, 10,771 bladder cancers, 8,293 kidney cancers and 1,800 testis cancers. Urological tumours represented at the time 22% of new cancer cases in France: 35% of male cancers (56,402 /161,025) and 4% of female cancers (4,772/117,228). The relative five-year survival for prostate cancers is high: 80%. It is below that of testis cancers (95% after 5 years), but higher than that of kidney cancers (64% in men and 63% in women after five years). Of all urological cancers, bladder cancers have the worst prognosis, since the relative five-year survival is 60% in men and especially 50% in women.

Prostate cancer is a public health problem. Currently, it is the most frequent cause of cancer, and the second most common cause of cancer mortality, in men in most developed countries. Its incidence in France in 2000 is close to 40 000 new cases, a consistent increase of 7,9% per year. One man in 8 in France will be diagnosed with prostate cancer in the course of his life. More than half of these cancers are diagnosed before 75 years, most often at a localized stage accessible to a curative treatment. The increasing practice of PSA testing and systematic prostatic biopsies are responsible for this rise in incidence. The mortality is stable at around 10 000 per year in France. Hereditary risk factors permit a definition of a target population for screening. Environmental factors are little known, but a diet rich in fat seems to be associated with a more elevated risk.

Radical prostatectomy is one of the standard treatment of localised prostate cancer. It is considered that cure is obtain if PSA value is undetectable (< 0,1 ng/mL) for at least 5 to 7 years post surgery. 8 to 9 men out of 10 are currently cured by prostatectomy if the cancer is detected at organ confined stage, with PSA < 10 ng/mL. Major technical progress related to patient setting, surgical approach, instrumentation, periprostatic fascial exposure and surgical strategy clearly decreased perioperative morbidity and late effects (erectile dysfunction and incontinence). Laparoscopic approach was described mainly by French teams since 1997 and represents a validated alternative to the gold standard suprapubic open approach.