Trends for Stage and Grade Group of Prostate Cancer in the US (2010-2016)

Urology. 2021 Mar:149:110-116. doi: 10.1016/j.urology.2020.11.022. Epub 2020 Nov 21.

Abstract

Objective: To quantify the yearly prostate cancer incidence per 100,000 men, comparing consecutive years from 2010 through 2016. In the years immediately following the 2011/2012 U.S. Preventive Services Task Force update to prostate specific antigen (PSA) screening guidelines, PSA screening, biopsy, and subsequent prostate cancer diagnosis and definitive local treatment have declined. We performed an analysis of stage and grade at diagnosis for prostate cancer in the US, in the years following the 2011/2012 update.

Methods/materials: This was a retrospective study performed using the Surveillance, Epidemiology, and End Results Program data. Inclusion criteria were men ≥ 40 years with prostate cancer diagnosed between the years 2010 and 2016.

Results: In total, 370,865 cases of prostate cancer were analyzed. Overall, the incidence of prostate cancer decreased from 522 to 327 cases per 100,000 persons from 2010 to 2016. Conversely, the rate of metastatic disease increased over this duration from 29 to 37 cases per 100,000 persons (P< .05). In patients ≥70 years, this increase was from 21 to 27 cases per 100,000 persons over the 7 years (P < .05). High-grade disease incidence did not change significantly over the study period, though low-grade disease incidence, (Grade Groups 1 and 2) decreased from 204 and 155 to 116 and 115 cases per 100,000 persons, respectively (P < .05).

Conclusions: In the years following the 2011/2012 recommendation against PSA screening, fewer localized prostate cancers and more distantly metastatic prostate cancers were diagnosed. Most increases in metastatic disease was among men ≥70 years.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Biopsy
  • Early Detection of Cancer / methods
  • Early Detection of Cancer / statistics & numerical data
  • Early Detection of Cancer / trends*
  • Humans
  • Incidence
  • Kallikreins / blood
  • Male
  • Middle Aged
  • Neoplasm Grading
  • Neoplasm Staging
  • Overdiagnosis / prevention & control*
  • Prostate / pathology*
  • Prostate-Specific Antigen / blood
  • Prostatic Neoplasms / blood
  • Prostatic Neoplasms / diagnosis*
  • Prostatic Neoplasms / epidemiology
  • Prostatic Neoplasms / pathology
  • Retrospective Studies
  • SEER Program / statistics & numerical data
  • United States / epidemiology

Substances

  • KLK3 protein, human
  • Kallikreins
  • Prostate-Specific Antigen