Temporal trends in rates of prostate cancer: declining incidence of advanced stage disease, 1974 to 1994.

PURPOSE

We examined the temporal trends in prostate cancer incidence and mortality rates in the Seattle-Puget Sound region.

MATERIALS AND METHODS

Prostate cancer incidence and treatment data collected by the Cancer Surveillance System, part of the Surveillance, Epidemiology, and End Results program, were analyzed for temporal trends in disease and treatment. Analyses were restricted to white and African-American men 35 years or older residing in the 13-county area of northwestern Washington state and diagnosed between 1974 and 1994. Data for the treatment analyses were limited to the time period 1983 through 1992.

RESULTS

Incidence of prostate cancer increased slowly from 1974 (169/100,000) to 1984 (230/100,000) and then rapidly to a peak in 1991 (486/100,000) before declining (293/100,000 in 1994). Mortality increased from 49/100,000 in 1974 to 67/100,000 in 1994. All stages of prostate cancer followed the same incidence trend peaking in 1991, except distant stage disease, which peaked in 1986 and subsequently declined by over 60% (p <0.001). Proportions of men undergoing radical prostatectomy increased from 1983 to 1992 with the biggest increase in men under 65 years old.

CONCLUSIONS

The incidence rate of prostate cancer in the Seattle-Puget Sound region is higher than the rate in some other regions of the country. This is likely due to widespread, more intense prostate specific antigen screening of the population in this region compared to other areas of the country. The incidence rate of prostate cancer in the Seattle-Puget Sound region has peaked and is now declining.