Prostate cancer is the most frequently diagnosed cancer in 112 countries and the leading cause of cancer death in 48 countries. It is the fifth leading cause of male cancer-related deaths worldwide, with more than 1.4 million newly diagnosed cases and 375,304 deaths reported annually.
According to the American Cancer Society, prostate cancer is the second leading cause of male cancer-related mortality in the United States (US), with 288,300 new cases and 34,700 deaths estimated in 2023. In addition, data from the National Cancer Institute reveals that the average American man has a 13% risk of being diagnosed with prostate cancer over their lifetime (the incidence increasing with age) and a 2.5% overall risk (1 out of every 41) of dying from it. The Centers for Disease Control and Prevention (CDC) predicts that for every 100 American men, 13 will be diagnosed with prostate cancer, and between 2 and 3 will die from the disease.
The incidence of prostate cancer in Black men is 70% higher than in White males. The lifetime risk of dying from prostate cancer varies in different ethnic groups, with Black men living in the US having the highest risk at 4.2%. American Indians and Alaskan Natives have a reported prostate cancer incidence of less than half that of Black men, but their death rate is slightly less.
According to the National Cancer Institute, the median age of death due to prostate cancer is 80 years, with 75% of prostate cancer-specific mortalities occurring in those older than 75. The average age at the time of diagnosis is 66 years. The US states with the highest prostate cancer mortality rates are Montana, Mississippi, and Vermont.
Prostate cancer is the most frequently diagnosed cancer in men (excluding skin cancer), which understandably raises concerns about the need for prostate cancer screening. However, most prostate cancers are slow-growing and may never become clinically evident. Data suggests that most men die of other causes before their prostate cancer becomes advanced or clinically significant. Definitive treatment is expensive and carries significant morbidity, thus making routine screening somewhat controversial.
Shared decision-making is strongly recommended before starting or discontinuing prostate cancer screening. According to the 2016 American Urological Association (AUA) study on the Implementation of Shared Decision Making in Urology, it should include the following features:
Both the physician and patient should be involved in the decision-making process.
Information should be freely shared between the physician and the patient.
Consensus should be built through the free expression of preferences.
The physician and patient should agree on implementing the selected plan.
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