AUA 2017: Increase in the Incidence of Advanced Prostate Cancer in the United States
In this study, the authors used the Surveillance Epidemiology, and End Results (SEER) database from 2004 to 2013 to assess the incidence of prostate cancers with distant or nodal metastases in men over 50 years of age. Among patients ≥75 years of age, the incidence of prostate cancer with nodal or distant metastases decreased from 2004 to 2011, however subsequently increased thereafter, and for men <75 years of age there was no change over time in the incidence of advanced disease. Pelvic lymph node metastasis in the absence of distant metastasis increased in men aged 50-74 years as well as those aged ≥75 years during the study period (both p<0.01). Limitations of this study include a lack of demographic and socioeconomic covariates, however a strength of the study is the population-level analysis allowing sufficient sample size to assess temporal trends associated with time periods of screening recommendations.
Based on the current study, it appears that older men have been most adversely affected by the 2012 USPSTF PSA screening recommendations, more commonly presenting with advanced disease for those ≥75 years of age. Certainly with last month’s USPSTF change for PSA screening from Grade D to C for men aged 55 to 69, hopefully this is the beginning of a pendulum swing back in the right direction.
Presented By: Jonathan Shoag, Weill Cornell Medical College, New York, NY, USA
Co-Authors: Art Sedrakyan, Joshua Halpern, Wei-Chun Hsu, Jim Hu
Written By: Zachary Klaassen, MD, Urologic Oncology Fellow, University of Toronto, Princess Margaret Cancer Centre
Twitter: @zklaassen_md
at the 2017 AUA Annual Meeting - May 12 - 16, 2017 – Boston, Massachusetts, USA