Background

Prostate cancer is the second most common cancer in men after skin cancer. Older men, African-American men and men who have a family history of prostate cancer have a greater risk of developing this cancer. In the United States, 11.2% of men have a lifetime risk of developing prostate cancer. In 2018 the number of newly diagnosed men in the US is expected to be 164,690. This accounts for 9.5% of all diagnosed cancers. At the same time, 19.5 men per 100,000 will die of the disease annually. In 2018, in the United States that number is estimated to be 29,430. This accounts for 4.8% of all cancer’s deaths.

Currently an estimated 3,000,000 men are living in the United States with prostate cancer. The National Cancer Institute – Surveillance, Epidemiology and End Results Program (SEER) estimates that 29,430 men died from prostate cancer in 2018 in the U.S. Prostate cancer deaths account for 9% of all male cancer deaths. The percent of new prostate cancer cases by age shows that most prostate cancer diagnoses do not just affect older men.

Statistics 

Percent of newly diagnosed cases by age group

< 20 no diagnoses
20- 34 no diagnosis
35-44 0.5 are diagnosed
45-54 9.0 % diagnosed
55-64 32.7 % diagnosed
65-74 38.8% diagnosed
75-84 15.1 % diagnosed
>85 3.9 % diagnosed

41.7 % of the diagnoses will be in men between 45 -64.
70.5% of men between the ages of 55 – 74 will be diagnosed with prostate cancer.

Percent of deaths by age group:

<20 no deaths
20-34 no deaths
35-44 0.1% of those diagnosed will die
45-54 1.5% of those diagnosed will die
55-64 9.2% of those diagnosed will die
65-74 21.7% of those diagnosed will die
75-84 34.0% of those diagnosed will die
>85 33.5% of those diagnosed will die

Discussion

The numbers indicate that prostate cancer is a killer. It is a disease that must be taken seriously.

Between 2011-2015 the estimated five-year incidence rate for all cancers declined by 2% and the prostate cancer incidence rate fell by 7%. This is attributed to a number of factors, not the least of which is the recommendation not to screen men under 70 for prostate cancer from the United States Preventive Services Task Force (USPSTF). Similarly, the American Cancer Society was not forthcoming in support of early detection for prostate cancer.

While the overall incidence rate of prostate cancer nationwide has declined, the rate of distant stage disease has increased. More men are now being diagnosed with advanced stage prostate cancer. This trend is alarming and may be the result of the 2008 recommendation of the United States Preventive Services Task Force on prostate cancer screening. The USPSTF report stated that there was “insufficient evidence for PSA based prostate cancer screening for men younger than 75”. The report also gave a “D” rating for screening men over 75. Many physicians stopped routine PSA screening based on the USPSTF recommendation. In 2012, the USPSTF changed its rating for PSA based prostate cancer screening to a “D” for all ages. In 2017, the recommendation for PSA based prostate cancer screening was changed to a “C” rating for men between the ages of 55-69. This rating means that the decision to be screened for prostate cancer should be an individual decision. Men and their care givers should have a discussion of the benefits and negatives of screening and eventual treatment. Clearly early detection saves lives, as evidenced by the increased rate in the number of distant stage diagnosis. Routine prostate cancer screening should be part of a man’s health plan.

As the oldest state in the nation, we can expect Maine to have a disproportionately high number of diagnosed cases and deaths from prostate cancer. It is anticipated that approximately 867 men will be diagnosed with prostate cancer annually in Maine and 159 will die from the disease. On the positive side, the mortality rate represents a 3.2% decline in the past five years. Multiple factors contribute to this.

Notes

The above information is from the National Cancer Institute – Surveillance, Epidemiology and End Results Program (SEER). Unless otherwise noted, the data reflects trends from 2011-2015. While the data, particularly on declining mortality rates, is improving on a national level as well as here in Maine, we must remember that prostate cancer is a killer. This disease is not to be taken lightly.