Incidence rates of early prostate cancer have continued to drop since the U.S. Preventive Services Task Force made their recommendation against routine prostate-specific antigen (PSA) testing in all men, according to a recent article that was published online by JAMA Oncology. Researchers with the American Cancer Society found a steep decline in prostate cancer diagnoses continued over the last few years since the U.S. Preventive Services Task Force dropped recommendations for routine screening for prostate cancer several years ago.
The study, which was led by Ahmedin Jemal, D.V.M., Ph.D., used federal cancer surveillance data to track prostate cancer incidence rates. Researchers found early-stage cases (disease confined to the prostate or nearby tissues) dropped 6% from 2012 to 2013. (For every 100,000 men ages 50 to 74, the number who were diagnosed with early disease fell from 357 to 335. The rate also fell among older men.) In the year following the change, incidence of early-stage prostate cancer dropped by 19% from 2011 to 2012.
“The nature of prostate cancer is you can find cancer, but it may not be lethal. But we can’t tell whether stage 3 cancer would be lethal with current technology. We need to monitor the later diagnosis and mortality [rates] to see if we’re missing cases that need to be caught.”
-Ahmedin Jemal, D.V.M., Ph.D.
To determine whether screening with the PSA (prostate-specific antigen) test also declined, Jemal’s team used national health survey data. Indeed, the percentage of men aged 50 to 74 who underwent PSA testing fell from about 37% in 2010 to 30% in 2013. Among men over 74, the percentage screened fell from 43% to 36% during that period. Other factors that may have contributed to the decline in incidence rates for early stage prostate cancer include changes in the prevalence of unknown risk factors and preventive measures.
The authors also found that from 2012 to 2013, early prostate cancer diagnosis rates per 100,000 men dropped from 356.5 to 335.4 in men aged 50 to 74. In men older than that, early cancer diagnoses fell from 379.2 to 353.6 per 100,000 men. Meanwhile, cases of advanced prostate cancer remained stable in both age groups. “Whether this pattern will lead to a future increase in the diagnosis of distant-stage disease and prostate cancer mortality requires long-term monitoring because of the slow-growing nature of this malignant neoplasm,” the authors wrote concluding their analysis.