Annual prostate cancer cases are projected to rise, new data show

The number of annual new prostate cancer cases are expected to rise from 1.4 million in 2020 to 2.9 million by 2040, according to a report recently published by The Lancet Commission.¹

The authors emphasize that the only way to effectively mitigate harm is to employ strategies for early detection and effective treatment.

The authors also project an 85% increase in the number of deaths from prostate cancer per year, which would bring the total number from 375,000 in 2020 to nearly 700,000 by 2040. The majority of these deaths will be among men in low- to middle-income countries.

According to the report, the rise will be largely driven by changing age structures and improved life expectancy.

“As more and more men around the world live to middle and old age, there will be an inevitable rise in the number of prostate cancer cases. We know this surge in cases is coming, so we need to start planning and take action now. Evidence-based interventions, such as improved early detection and education programs, will help to save lives and prevent ill health from prostate cancer in the years to come. This is especially true for low- and middle-income countries which will bear the overwhelming brunt of future cases,” said co-author Nicholas D. James, PhD, in a news release on the data.² James is a professor of prostate and bladder cancer research at The Institute of Cancer Research in London, and a consultant clinical oncologist at The Royal Marsden NHS Foundation Trust.

The authors of the report call for interventions to improve the health of men across the world, including global improvements in early detection programs for prostate cancer. To this end, they recommend the use of MRI in combination with prostate-specific antigen (PSA) testing for those men at high-risk of prostate cancer in high-income countries, such as those with a family history, those of African origin, and those harboring a BRCA2 mutation, to reduce over-diagnosis and over-treatment while still detecting potentially lethal disease. For those with high-risk of disease, they suggest biopsies be conducted in addition to MRIs.

Among men in low- to middle-income countries, the authors highlight the urgent need to conduct cancer screening trials to assess the effectiveness of population level PSA testing.

Further, the authors highlight the need to improve awareness among those in low- to middle-income countries as to the dangers of metastatic prostate cancer, as well as on the availability of treatments that can prolong survival and decrease suffering, such as hormone therapy. The report also notes a need to increase availability and access to treatments for advanced prostate cancer among men in these populations.

Additionally, there is a need to expand early diagnostic capabilities in low- to middle-income countries.

“The issue in low- and middle-income countries is that late diagnosis of prostate cancer is the norm. Improved outreach programs are needed to better inform people of the key signs to look out for and what to do next. Implementing these in tandem with investments in cost-effective early diagnostic systems will be key to preventing deaths from prostate cancer as cases inevitably rise with a global aging population,” said co-author James N’Dow, MD, in the news release on the report.² N’Dow is the chair of surgery at the University of Aberdeen and the founder of Horizons Trust & Horizons Clinic in Gambia.

The authors of the analysis also call for a mandatory recording of ethnicity in clinical trials, emphasizing the need to better understand prostate cancer in men who are not of European origin. Other key recommendations include integrating artificial intelligence for scans and biopsies for early diagnosis of prostate cancer, improving education and outreach using social and traditional media and smartphones, focusing on men’s health more broadly, and addressing the shortages of specialist surgeons and radiotherapy equipment in low- to middle-income countries.³

The authors emphasize that the only way to effectively mitigate harm from the rise in prostate cancer cases is to employ strategies for early detection and effective treatment.

N’Dow concluded in the news release,² “As well as the obvious direct effects on individual men’s health, rising numbers of cases and deaths from prostate cancer could have huge economic and social impacts on families in [low- to middle-income countries]. Men in these countries are very often a family’s main breadwinner, so if they die or become seriously ill, this can lead to families facing major economic hardship. By preparing now for the upcoming surge in prostate cancer cases, with a particular emphasis on improved education and earlier diagnosis programs, many of these harms could be reduced substantially.”

References

1. James ND, Tannock I, N’Dow J, et al. The Lancet Commission on prostate cancer: planning for the surge in cases. The Lancet. Published online April 4, 2024. Accessed April 5, 2024. https://www.thelancet.com/commissions/prostate-cancer

2. Prostate cancer cases expected to double worldwide between 2020 and 2040, new analysis suggests. News release. Prostate Cancer Foundation. April 4, 2024. Accessed April 5, 2024. https://www.pcf.org/news/prostate-cancer-cases-expected-to-double-worldwide-between-2020-and-2040-new-analysis-suggests/#:~:text=The%20Lancet%3A%20Cases%20of%20prostate,launched%20by%20a%20presentation%20at

3. Sylvester physician co-authors global plan to combat prostate cancer. News release. Sylvester Comprehensive Cancer Center. April 4, 2024. Accessed April 5, 2024. https://www.newswise.com/articles/sylvester-physician-co-authors-global-plan-to-combat-prostate-cancer