Prostate cancer cases to double worldwide over two decades: Study

AFP , Friday 12 Apr 2024

Prostate cancer cases are expected to double worldwide between 2020 and 2040, new analysis suggests.



The data suggests annual prostate cancer cases are projected to rise from 1.4 million in 2020 to 2.9 million in 2040.

And annual deaths from the disease are projected to increase by 85% to almost 700,000 over the same timeframe, mainly among men in low- and middle-income countries (LMICs).

Ageing populations and increasing life expectancy will lead to higher numbers of older men in coming years.

The main risk factors for prostate cancer - such as being aged 50 or older and having a family history of the disease - are unavoidable, so it will not be possible to prevent the upcoming surge in cases through lifestyle changes or public health interventions, the researchers suggest.

The Lancet Commission on prostate cancer argues that the informed choice programme for prostate cancer screening with testing, which is common in high-income countries (HICs), may lead to over-testing and unnecessary treatment in older men, and under-testing in high-risk younger men.

Instead, the authors advocate for early-detection programmes for those at high risk.

The commission also calls for urgent programmes to raise awareness of prostate cancer and for improvements in early diagnosis and treatment in LMICs.

More research involving men of different ethnicities, especially those of West African descent, is needed, the researchers say.

Prostate cancer is a major cause of death and disability, accounting for 15% of all male cancers, and is the most common form of male cancer in more than half of the world's countries.

Data suggests there were 56,780 estimated prostate cancer cases in 2020 and this is predicted to increase to 75,066 cases by 2040 (if incidence rates stay the same), a 32% increase over 20 years.

If there was a 1% decline per year until 2040, as is predicted for the Northern Europe region in the study, the predicted number in 2040 would still increase to 61,397 new cases, an 8% increase over 20 years.

With an annual 1% increase in cases, the predicted number would be 91,544 in 2040, a 61% increase over 20 years.

In HICs, screening for prostate cancer often involves the PSA test, a blood test that measures levels of a protein called prostate-specific antigen (PSA).

The current approach to prostate cancer diagnosis in many HICs relies on "informed choice" PSA testing, where men aged 50 or over with no symptoms can request a PSA test from their doctor after a discussion of the risks and benefits.

According to the commission, there is evidence to suggest this approach leads to over-testing in low-risk older men but does not increase detection of prostate cancer in younger men at higher risk.

Instead, the authors recommend using MRI scans in combination with PSA testing to screen men at high risk of prostate cancer in HICs.

This includes those with a family history of the disease, those of African origin and those carrying the BRCA2 mutation.

The experts say new approaches are needed to enable earlier diagnosis in LMICs, as most men in these countries present with an advanced form of disease where the cancer has spread to other parts of the body, often the bones.

Men with late-stage prostate cancer are much less likely to survive for a long period of time than those who are diagnosed early.

The experts suggest that a major barrier to improved prostate cancer care in LMICs is a lack of trained staff and specialist facilities.

Urgent measures are therefore needed to build surgical and radiotherapy capacity in these countries, they say.

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