Aggressive Prostate Cancer Diagnoses Declining in US

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Study of men diagnosed with PCa from 2008 to 2013 found declining incidence among whites, blacks, Hispanics, and Asian/Pacific Islanders.
Study of men diagnosed with PCa from 2008 to 2013 found declining incidence among whites, blacks, Hispanics, and Asian/Pacific Islanders.

High Gleason score prostate cancer (PCa) in the United States is declining in incidence among all races, according to study findings presented at the Society of Urologic Oncology 17th annual meeting in San Antonio, Texas.

Using the Surveillance, Epidemiology and End Results (SEER) database, a team at Saint Louis University in Missouri led by Sameer Siddiqui, MD, examined the effect of the 2008 and 2012 guidelines issued by the US Preventive Services Task Force (USPSTF) stating there was insufficient evidence to support PCa screening. The study included 337,504 men diagnosed with PCa from 2008 to 2013. They had a mean age range of 65 to 74 years. The investigators categorized Gleason score (GS) as low (GS 2–6), intermediate (GS 7), and high (GS 8–10). Low, intermediate, and high GS were recorded for 42%, 36%, and 16% of the men, respectively. The GS was unknown for 6% of the patients.

From 2008 to 2013, the incidence of GS 8–10 disease (per 100,000 men) decreased from 21.7 to 19.4 among white men, 39.5 to 33.7 among black men, 22.8 to 19.0 for Hispanic men, and 17.7 to 13.8 among Asian/Pacific islanders. The trend suggests decreased diagnosis of aggressive PCa following issuance of the USPSTF guidelines, according to the investigators.

Over the 6-year study period, black men had the highest cumulative incidence of low Gleason score cancer (76.2 per 100,000), followed by white men (52.9 per 100,000), the researchers reported in a poster presentation. The cumulative incidence of high Gleason score cancer was 37.5 and 21.0 per 100,000 for black and white men, respectively.

The annual percentage change (APC) declined significantly among all races for low GS cancer (-8.9% for whites, -8.6% for blacks, -8.6% for Hispanics, and -8.7% for Asian/Pacific Islanders) and intermediate GS cancer (-8.6%, -6.5%, -9.2%, and -9.9% respectively). The APC for high GS cancer declined significantly for blacks and Hispanics (-3.5% and -4.4%, respectively), but did not change significantly among whites and Asian/Pacific islanders.

Reference

Au D, Syed J, Siddiqui S. Incidence of prostate cancer stratified by race and Gleason score: A SEER database analysis following USPSTF screening recommendations. Poster presented at the Society of Urologic Oncology 17th annual meeting in San Antonio, Texas. Poster 98.

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