Incidence and Prevalence of Prostate Cancer

US Pharm. 2009;34(8):10. 

Among men, prostate cancer (PC) is the second most common type of cancer and the third leading cause of cancer death, according to the National Cancer Institute. Annually, PC is the diagnosis in one of every three men found to have cancer. PC affects 234,000 U.S. men each year, with death occurring in 27,000. The Prostate Cancer Foundation reported that one new case of PC occurs every 2.5 minutes and one death from it occurs every 19 minutes. One in six males (16%) born between 2004 and 2006 will be diagnosed with PC during his lifetime, with 8% developing it between 50 and 70 years of age.

Trends

From 2002 to 2006, median age at diagnosis was 68 years; 9% of patients were diagnosed between ages 45 and 54, 29% between 55 and 64, 36% between 65 and 74, 21% between 75 and 84, and 5% at 85 or older. Overall annual incidence was 159.3 per 100,000 men.

During this period, median age at death from PC was 80 years, with 7% of deaths occurring between ages 55 and 64; 20% between 65 and 74; 41% between 75 and 84; and 30% at 85 or older. Overall annual death rate was 25.6 per 100,000 men.

The introduction of prostate-specific antigen screening in the late 1980s significantly increased the number of men (17%) diagnosed with localized PC. Between 1988 and 1992, 80% of newly diagnosed men had clinically organ-confined disease that was potentially curable. Subsequently there was a 12% decrease in diagnosis per year between 1992 and 1995 and a significant 3% decrease per year between 2001 and 2006.

From 1999 to 2005, overall 5-year survival of PC patients versus the general population was 99.7%. Five-year relative survival rates were 99.9% for white men and 96.5% for black men. Death rates for PC are nearly 2.5 times higher in African American men than in white men, according to the National Institutes of Health.

Eighty percent of PC cases were diagnosed while disease was confined to the primary site (localized); 12% were diagnosed after it had spread to regional lymph nodes or directly beyond the primary site (regional); and 4% were diagnosed after it had metastasized (distant). Five-year survival rates were 100% for localized, 100% for regional, and 30.6% for distant disease. 

Conclusion

Because 90% of PCs are detected early, the cure rate is high; nearly 100% of men diagnosed at this stage are disease-free after 5 years. Obesity increases the risk of recurrence and death after radiation therapy, however.

Fifty medicines to treat PC are in development. One potential vaccine in clinical trials has tripled the survival rate in advanced PC.