The Rise of Metastatic Prostate Cancer Incidence in the United States

The changes in the screening process of prostate cancer have led to changes in the overall incidences of the disease. What is not known though, is whether it is the relaxed screening that caused the changes in the incidence of metastatic and advanced prostate cancer at diagnosis. Since 2007, the incidence has increased among men in the age group that is likely to benefit from the definitive treatment of the disease, calling for the need for refinements in the screening and treatment of prostate cancer.

PSA screening is the backbone of detecting early prostate cancer across the world. For the past decade, PSA screening practices have experienced substantial shifts resulting in reduced screening and prostate cancer incidence. Concerns have been raised regarding over-detection and overtreatment due to PSA screening.

The relationship between relaxed screening and the increasing yearly incidence of advanced prostate cancer was analyzed. It was observed that 3% of the men had prostate cancer metastases at diagnosis while the rest had localized disease with 20% high, 45% intermediate and 32% low.

This controversy has caused a backlash against PSA screening which has impacted greatly on early detection of prostate cancer and if the changes will cause a delay in diagnosis especially with the increased rates of metastatic prostate cancer which is incurable.

After identifying men who were diagnosed with prostate cancer using the national database and various health care facilities in the U.S., it was found that the incidence of men with metastatic disease was higher, and the rate of high-risk prostate cancer remained the same.

It may be argued that the high incidence of metastasis is due to early detection through imaging, but the PSA diagnosis of metastatic cancer in men was significantly high, which argues against the shift towards low volume metastatic disease.

More work should be done including adjusting age differences to assess the metastatic rates and not just the incidence. It is evident that PSA is not the cause of these shifts. Whether smarter screening or less overtreatment needs to be exercised in order to lower the harms and reverse the trends is a fact that remains to be seen.

About Author

Dr. Echt and his team at the Prostate Seed Institute offer the most highly sophisticated methods of radiation therapy available in the United States, equal to that found in major medical center and academic settings. These include prostate seed implantation, high dose radiation implants, and external beam radiation with image-guided and intensity-modulated (IGRT and IMRT) capabilities.

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At The Prostate Seed Institute, we work directly with patients and their families to determine which treatment option is right for them. Our goal is to help men understand what it means to have been diagnosed with prostate cancer and to empower them to explore all of their treatment options. Our main mission is to guide a patient on a path that leads to the best possible results in every single case, taking into account the circumstances that are particular to the patient … … … …..

Dr. Echt and his team at the Prostate Seed Institute offer the most highly sophisticated methods of radiation therapy available in the United States, equal to that found in major medical center and academic settings. These include prostate seed impla