Federal researchers warn they have seen an increasing number of advanced stage prostate cancer cases diagnosed over the past two decades, even while overall prostate cancer rates have declined in the United States.
According to findings published earlier this month in the U.S. Centers of Disease Control and Prevention (CDC) Morbidity and Mortality Weekly Report, prostate cancer cases seem to be getting diagnosed at later stages due to a lack of early screening, decreasing men’s risk of survival.
CDC researchers analyzed data on incidence and survival of prostate cancer in the U.S. using population-based cancer registries that contribute to U.S. Cancer Statistics. There were 3.1 million new cases of prostate cancer recorded from 2003 to 2017.
During that same time period, the number of prostate cancer cases in the late stage increased from 4% in 2003 to 8% in 2017. However, the five year survival for late stage prostate cancer also improved during that time. From 2000 to 2005 survival rates were 29%. By 2011 to 2016, roughly 32% of late stage patients had positive five-year survival outlooks.
Five year survival rates were highest among Asian/Pacific Islanders at 42%, with Hispanics at 37% five year survival rates, American Indian/Alaska Natives at 32%, Black men at 31%, and White men at 29%.
Understanding diagnosis rates and survival rates among different patients may help doctors guide testing and treatment, the CDC noted.
Researchers said the spike in advanced stage cancers was somewhat inevitable given that in 2012 the U.S. Preventive Services Task Force recommended against the use of routine prostate cancer screenings, specifically the prostate-specific antigen (PSA) test. This led to more men not being screened until they had much later stages of cancer.
The screening recommendations were not reversed until 2018. This means the increase in late stage prostate cancer diagnoses will continue to increase for a time.
Men should undergo screening early, including the PSA test, according to the current recommendations. Then if screening leads to questionable results, the patient should discuss their options or further diagnostic testing with their doctor to prevent late stage diagnosis.
Among men in the U.S., prostate cancer is the second leading cause of cancer-related death. There are more than 3 million cases of prostate cancer in the U.S. every year. Prostate cancer is largely treatable during the early stages, but once it spreads it is most often lethal, making early diagnosis the key to improved treatment and survival.