The incidence of prostate cancer and mortality have decreased in most countries

ATLANTA – Prostate cancer incidence and mortality rates are declining or stabilizing in most parts of the world, with the United States recording the largest decline in incidence, according to results presented at the AACR Annual Meeting 2019, from March 29th to April 3rd.

Despite the trend of declining or stabilizing rates, prostate cancer remains the second most-diagnosed cancer and the sixth leading cause of cancer death among men worldwide, said MaryBeth Freeman, lead author of the ### 39, Study, Surveillance Research, at the American Cancer Society in Atlanta.

"Previous studies have shown significant variation in prostate cancer rates, due to factors such as detection practices, treatment availability, and genetic factors," Freeman said. "By comparing rates from different countries, we can badess the differences between detection practices and treatment improvements."

The researchers examined trends in prostate cancer incidence and mortality across five continents using the most recent data on cancer incidence provided by the International Agency for Research on Cancer. and mortality data provided by the World Health Organization. They examined long-term trends, from 1980 to 2012, for 38 countries that provided "high quality" data (information considered accurate, timely and complete) and short-term trends for 44 countries for which data were available. Incidence were available and for 71 countries with available mortality data. The short-term data covered a five-year period that varied slightly from country to country, but most often reflected 2008-2012.

Of the 44 countries examined for incidence data, prostate cancer rates during the last five-year period increased in four countries, with Bulgaria recording the largest increase. Rates declined in seven countries, with the United States recording the largest decline. Rates stabilized in the remaining 33 countries.

Of the 71 countries badyzed for mortality rates, rates declined in 14 countries, increased in three countries and remained stable in 54 countries.

Globally, in 2012, prostate cancer was the most commonly diagnosed cancer in men in 96 countries and the leading cause of death in 51 countries.

Other findings:
– The highest incidence rates in the last five years were in Brazil, Lithuania and Australia.
– The lowest incidence rates of the last five-year period were observed in India, Thailand and Bahrain.
– The highest death rates of the last five-year period have been observed in the Caribbean, including Barbados, Trinidad and Tobago and Cuba. South Africa; Lithuania; Estonia; and Latvia.
– The lowest mortality rates of the last five years have been recorded in Thailand and Turkmenistan.

Freeman said she and her colleagues were surprised and delighted that so many countries had managed to stabilize prostate cancer rates, which meant that rates had not increased during the reporting period. In the coming years, global health experts hope that more countries will move from stability to lower incidence and mortality rates.

Freeman said that the study confirmed the impact of screening for prostate specific antigen (PSA). She explained that in the United States, prostate cancer incidence rates increased between the 1980s and the early 1990s, and then declined between the mid-2000s and 2015s, mainly because of the increased use of PSA screening. This type of screening is less available in low-income countries, contributing to advanced diagnosis and higher mortality rates, Freeman said.

Freeman pointed out that some countries are considering reducing recommendations for PSA testing, as this would lead to the diagnosis and excessive treatment of cases of prostate cancer that would never become symptomatic.

"Overall, patients should have an informed discussion with their providers about the pros and cons of the PSA test for the detection of prostate cancer," she said. "Future studies should track trends in mortality rates and advanced stages of the disease to badess the impact of the reduction in PSA testing in several countries."

Freeman said that one of the limitations of the study was the variability of data between different countries. For example, some countries may have collected data only from certain geographic areas, while others may have collected data from across the country. However, she added that the breadth of data in this study has allowed researchers to provide a comprehensive picture of the incidence and mortality of prostate cancer worldwide.

###

This study was funded by the American Cancer Society. Freeman does not declare any conflict of interest.

Warning: AAAS and EurekAlert! are not responsible for the accuracy of the news releases published on EurekAlert! contributing institutions or for the use of any information via the EurekAlert system.