Rates of Metastatic Prostate Cancer Are Significantly Increasing

A new study suggests that the incidence of metastatic prostate cancer in the United States has risen dramatically in recent years.

A team including researchers from Northwestern University in Chicago, Illinois, identified all men diagnosed with prostate cancer in the National Cancer Data Base from 2004 to 2013 at 1089 different health care facilities in the United States. The investigators used joinpoint regressions to model annual percentage changes in the incidence of prostate cancer based on stage, relative to that of 2004.
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The investigators found that, beginning in 2007, the incidence of metastatic prostate cancer has increased, particularly among men in the age group thought most likely to benefit from definitive treatment for prostate cancer. This finding, according to the authors, highlights the continued need for nationwide refinements in prostate cancer screening and treatment.

The study "shows that overall rates of prostate cancer diagnoses and deaths are down," said Edward M. Schaeffer, MD, PhD, a coauthor of the study. "This we already know."

"What we did find that was new was that rates of metastatic disease were on the rise," said Schaeffer, chair of the Department of Urology at the Northwestern University Feinberg School of Medicine.

A diagnosis of metastatic disease "is almost always fatal within 5 years, whereas localized disease [is] almost always curable," Dr Schaeffer said.

"Why this trend? This is the focus of our current research," he said. "I think an open discussion between MDs and their patients is the best approach to prostate cancer screening. This will allow for discussion of potential risks of the disease in balance with the individual patient’s risk of death from other causes, such as hypertension, obesity and so on.

—Mark McGraw

Reference
Weiner AB, Matulewicz RS, Eggener SE, Schaeffer EM. Increasing incidence of metastatic prostate cancer in the United States (2004-2013) [published online July 19, 2016]. Prostate Cancer Prostatic Dis. doi:10.1038/pcan.2016.30.