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Rising Incidence of Prostate Cancer and the Impact of Early Screening

Updated: Jan 20

Commentary by Dr. Donald Greig


November ‘Movember’ is men’s health month with a heavy emphasis focusing on prostate cancer.


Prostate cancer has emerged as a significant public health concern globally, with rising incidence rates reported in various regions. This increase can be attributed to several factors, including aging populations, improved diagnostic techniques, and greater awareness of the disease. As men live longer, the likelihood of developing prostate cancer naturally increases. Additionally, the widespread use of prostate-specific antigen (PSA) testing has led to more cases being diagnosed, often at earlier stages.


Epidemiology and Trends

The World Health Organization (WHO) highlights that prostate cancer is now one of the most commonly diagnosed cancers among men, surpassing even lung cancer in some countries. In particular, regions with advanced healthcare systems have observed a notable uptick in cases, raising questions about the balance between overdiagnosis and the potential benefits of early detection.


Importance of Early Detection

Early detection plays a crucial role in managing prostate cancer effectively. When diagnosed at an early stage, the chances of successful treatment are significantly improved, leading to better outcomes in terms of morbidity and mortality. Screening methods, particularly PSA testing, have been instrumental in identifying prostate cancer before it progresses to more advanced stages where treatment options become limited and less effective.


Screening Controversies

Despite the benefits, prostate cancer screening is not without controversy. Critics argue that PSA testing can lead to overdiagnosis and overtreatment, exposing patients to unnecessary risks and side effects. This has led to recommendations for more individualized screening approaches, taking into account a man's age, family history, and overall health.


Advancements in Screening Techniques

Recent advancements in screening techniques, including the use of multiparametric MRI and genetic testing, offer promising avenues for improving detection rates while mitigating the risks associated with overdiagnosis. These methods can help identify aggressive cancers that require immediate intervention, while sparing patients with indolent forms of the disease from unnecessary treatment.


The Role of Awareness and Education

Public health initiatives aimed at raising awareness about prostate cancer and the importance of screening are critical. Men, especially those at higher risk due to family history or ethnicity, should be encouraged to discuss prostate cancer screening with their healthcare providers. Education can empower patients to make informed decisions regarding their health and screening options.


The rising incidence of prostate cancer presents a complex challenge for global health. While the benefits of early detection through screening are clear, it is essential to navigate the associated risks thoughtfully. A balanced approach that combines awareness, personalized screening strategies, and advancements in diagnostic technology will be key to improving outcomes for men diagnosed with prostate cancer. Continued research and dialogue among healthcare providers, patients, and policymakers will be vital in addressing this growing public health issue.


The Times article focuses on the doubling of the incidence of prostate cancer in the next 2 decades and some of the explanations behind it.



Article by Poppy Koronka

The Lancet commission suggested that those at high risk of prostate cancer should be targeted with MRI scans Prostate cancer cases are expected to double worldwide between 2020 and 2040, new analysis suggests.

The data suggests that annual prostate cancer cases will rise from 1.4 million in 2020 to 2.9 million in 2040 as men live longer lives.

In Britain prostate cancer is the second most common cause of cancer deaths in men and is the most common form of male cancer in more than half of countries worldwide. The researchers estimated that there were 56,780 prostate cancer cases in Britain in 2020, which would rise to 75,066 cases by 2040 if incidence rates stayed the same — a 32 per cent increase in 20 years.

Nick James, the lead author of the commission, and professor of prostate and bladder cancer research at the Institute of Cancer Research, London, said: “As more and more men around the world live to middle and old age, there will be an inevitable rise in the number of prostate cancer cases. We know this surge in cases is coming, so we need to start planning and take action now.


“Evidence-based interventions, such as improved early detection and education programmes, will help to save lives and prevent ill-health from prostate cancer in the years to come. This is especially true for low and middle-income countries which will bear the overwhelming brunt of future cases.”

The Lancet Commission on Prostate Cancer said that the main risk factors for prostate cancer, such as being over 50 and having a family history of the disease, were unavoidable, meaning that lifestyle or public health interventions would not prevent a surge in cases.

It argued that the common method of screening in the UK and other high-income countries — the informed choice programme — could lead to over-testing and unnecessary treatment in older men, and under-testing in young men. In the UK, men aged 50 and over with no symptoms can ask for a PSA test, which looks for proteins made by cancerous cells but can produce false positives.

The commission suggested that there should instead be early detection programmes for those at high risk, using MRI scans on combination with PSA testing.

Cancer Research UK’s director of evidence and implementation, Naser Turabi, said: “This study reflects the impact of a growing, ageing population on rising numbers of people being diagnosed with prostate cancer worldwide.

“Here in the UK, cases have risen by around 150 per cent in the last 25 years. We support the Lancet’s call for more research into the early detection of prostate cancer.”

The Lancet Commission on Prostate Cancer will be launched at the 39th Annual European Association of Urology Congress in Paris on Saturday.


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