• Gold Coast Urologist

The latest on Prostate Cancer epidemiology

“Prostate cancer is the second most frequent malignancy (after lung cancer) in men worldwide, counting 1,276,106 new cases and causing 358,989 deaths (3.8% of all deaths caused by cancer in men) in 2018”. In addition, the disease is the “fifth leading cause of death worldwide”. It is clear as to why much research over the years have been conducted to gain better understanding of the aetiology and risk factors associated with the disease in the hope of prevention and reducing male deaths.

Incidence and morality of prostate cancer is found to increase with age specifically in elderly men greater than 65 years. “1 in 350 men under the age of 50 years will be diagnosed with prostate cancer, the incidence rate increases up to 1 in every 52 men for ages 50 to 59 years. The incidence rate is nearly 60%in men over the age of 65 years”. Interestingly, Oceania, North America and Europe have the highest age-standardised rate, while Africa and Asia have lower incidence than those developed countries. It is unclear as to why this is the case but they attribute PSA testing and its prevalence in these counties and the potential to over diagnose. In addition, these statistical differences worldwide may also be due environmental factors, screening methods as well as differences in healthcare access.

Prostate cancer risk factors are largely unknown in comparison to other cancers those risk factors which are known to include; “advanced age, ethnicity, genetic factors and family history”. Others which are associated include “ diet, obesity and physical inactivity, inflammation, hyperglycemia, infections, and environmental exposure to chemicals or ionizing radiation”. With regards to family history, which is a well-established prostate cancer risk, “It is estimated that about 20% of patients with prostate cancer report a family history, which may develop not only because of shared genes but also for a similar pattern of exposure to certain environmental carcinogens and common lifestyle habits”.

“The incidence rates are decreasing in the USA, Australia and Canada since the 1990s as a result of PSA testing” and “the 5 year survival rate in the USA for men diagnosed with prostate cancer is around 9%. This is a growth from 2003-2009 that had a reduced survival rate of 83%”. As the most common malignancy in men, it is important that research and awareness continues.

Article reference: Rawla P, 2019 “Epidemiology of Prostate Cancer”, World Journal of Oncology, Volume 10, 2, pp63-89.