Rates of advanced prostate cancer are on the rise, new data show

“We must address these shifts in prostate cancer, especially in the Black community," said William Dahut, MD.

Cases of advanced prostate cancer are increasing for the first time in 20 years, according to new data from the Cancer Statistics, 2023 report released by The American Cancer Society (ACS).^1,2,3

“The increasing percentage of men presenting with advanced prostate cancer, which is much more difficult to treat and often incurable, is highly discouraging. In order to end cancer as we know it, for everyone, it is imperative for us to focus on cancers where trends for incidence and mortality are going in the wrong direction,” stated chief executive officer for the ACS Karen E. Knudsen, PhD, MBA, in a news release on the findings.²

An analysis of the data showed that prostate cancer cases have increased by 3% per year from 2014 to 2019, with the incidence rate higher among Black men compared with White men. The leading cause of this overall increase was the diagnosis of advanced cases of disease, which has increased by 4% to 5% annually since 2011. The proportion of men diagnosed with distant-stage disease has doubled in that timeframe.

The rise in cases will likely lead to an increase in prostate cancer mortality over time, according to Jeff Michalski, MD, MBA, president of the American Society for Radiation Oncology (ASTRO) and a professor at Washington University School of Medicine in St. Louis, Missouri. Michalski also suggested that the report by the ACS is a signal to the US Preventative Services Task Force (USPSTF) to update their screening recommendations, which currently recommend against prostate-specific antigen (PSA) screening for men of all ages.

The data from the ACS report echo other findings reported in JAMA Oncology⁴ and presented at the ASTRO 2022 annual meeting,⁵ which showed an increase in metastatic cancer incidence rates over the time period studied (2005- 2019). The study cohort consisted of men aged 40 and older who received care at a facility in the US Veterans Health Administration.

Findings from that study also showed a decrease in PSA screening over the time period studied, which included the time in which USPSTF guidelines were updated to recommend against PSA screening. Investigators found that facilities with lower rates of PSA screening tended to have higher incidence rates of metastatic prostate cancer.

The recently released ACS data adds on to these findings, suggesting a need to address the rising rates of prostate cancer, according to William Dahut, MD, chief scientific officer at the ACS.

“We must address these shifts in prostate cancer, especially in the Black community, since the incidence of prostate cancer in Black men is 70% higher than in White men and prostate cancer mortality rates in Black men are approximately two to four times higher than those in every other racial and ethnic group,” Dahut stated in the news release.²

IMPACT

The ACS is already working to address the growing number of advanced prostate cancer cases by launching IMPACT, an initiative that will work toward “Improving Mortality from Prostate Cancer Together.”

The initiative will aim to fund cancer research programs to help identify which patients may be most at-risk for prostate cancer. It also seeks to expand patient access to prostate cancer screening and care as well as advocate for policies that address the burden of prostate cancer on the US population.

“This groundbreaking initiative will leverage our unique organizational strengths to mobilize resources across advocacy, patient support, and research. ACS is committed to utilizing a tripartite strategy to reverse prostate cancer disparities and reduce death rates from prostate cancer in all demographics and disparities for Black men by 2035,” said Knudsen.²

IMPACT is currently working to establish community partnerships and stakeholders to help leverage their mission.

References

1. Prostate cancer experts available to discuss new ACS data and need to reconsider screening guidelines. News release. American Society for Radiation Oncology (ASTRO). January 13, 2023. Accessed January 17, 2023.https://www.newswise.com/articles/prostate-cancer-experts-available-to-discuss-new-acs-data-and-need-to-reconsider-screening-guidelines?sc=mwhr&xy=10016681

2. American Cancer Society releases latest cancer statistics, launches Initiative to address prostate cancer resurgence and disparities. News release. American Cancer Society. January 12, 2023. Accessed January 17, 2023. http://pressroom.cancer.org/FactsandFigures23

3. Siegel RL, Miller KD, Wagle NS, Jemal A. Cancer statistics, 2023. CA Cancer J Clin. 2023;73(1):17-48. doi: 10.3322/caac.21763

4. Bryant AK, Lee KM, Alba PR, et al. Association of prostate-specific antigen screening rates with subsequent metastatic prostate cancer incidence at US Veterans Health Administration. JAMA Oncology. Published online October 24, 2022. Accessed January 17, 2023. doi:10.1001/jamaoncol.2022.4319

5. ASTRO Web. ASTRO 2022 News Briefing #1. Vimeo. Accessed January 17, 2023. https://vimeo.com/763465202#t=8m55s