The number of new cases of metastatic prostate cancer climbed 72 percent in the past decade from 2004 to 2013, reports a new Northwestern Medicine study. The report considers whether a recent trend of fewer men being screened may be contributing to the rise, or whether the disease has become more aggressive -- or both. The largest increase in new cases was among men 55 to 69 years old, which rose 92 percent in the past decade. This rise is particularly troubling, the authors said, because men in this age group are believed to benefit most from prostate cancer screening and early treatment.In addition, the average PSA (prostate-specific antigen) of men who were diagnosed with metastatic prostate cancer in 2013 was 49, nearly double that for men diagnosed in 2004 with an average PSA of 25, indicating a greater extent of disease at diagnosis.
In the the article by Weiner et al they note:
Beginning in 2007, the incidence of metastatic
prostate cancer has increased especially among men in the age group
thought most likely to benefit from definitive treatment for prostate
cancer. These data highlight the continued need for nationwide
refinements in prostate cancer screening and treatment.....Although the social and biologic factors underlying these PSA escapes
and rising metastatic prostate cancer cases are unknown, the
implications of these recent trends highlight the continued need for
nationwide refinements in prostate cancer screening and treatment to
prevent the morbidity and mortality associated with metastatic prostate
cancer. This will be particularly critical for population health
economics in the United States considering the added cost of care for
metastatic prostate cancer and an aging constituency whose population over the age 65 years will double to over a projected 80 million by the year 2050.
In addition, our findings and forthcoming changes in the number of
elderly individuals should provide impetus to improve treatments for men
with metastatic prostate cancer whose cancer-specific survival has not
changed significantly in the past two decades.