Prostate cancer epidemiology in the United States.

BACKGROUND

Prostate cancer is a significant public health issue in the United States. It is the most commonly diagnosed non-skin cancer and the second leading cause of cancer death. The American Cancer Society estimates that in 2011, 240,890 men were diagnosed with prostate cancer and 33,720 men died of it.

METHODS

A review of the peer-reviewed literature was conducted: American Cancer Society, National Cancer Institute Surveillance, Epidemiology and End Results. Program data were assessed to describe trends in incidence, mortality, and survival rates and look at other predictors of risk of prostate cancer diagnosis and death.

RESULTS

Since 1985, there have been significant changing trends in prostate cancer incidence, mortality, and survival rates, as well as changes in the age distribution of the population diagnosed and even in the distribution of pathologies at diagnosis. Major risk factors for diagnosis include age, family history, race, and screening behavior.

CONCLUSION

While prostate cancer remains largely a disease diagnosed in older men (over age 65), screening has increased risk of diagnosis among men in their 40s and 50s. The incidence rates and 5-year survival rates are heavily influenced by the introduction of serum prostate-specific antigen (PSA) and widespread screening. The effects of PSA usage and screening on mortality rates are less certain. Outcome studies among men treated with radical prostatectomy show that greater than 30% relapse rates are common. This suggests that many men who are diagnosed with "localized early stage disease" actually have "apparently localized early stage disease," which is really low volume metastatic disease.