Older men are more likely to be diagnosed with higher grade prostate cancer (PCa), investigators concluded in a recent paper published in Cancer.
In a cross-sectional population-based study of 20,356 men diagnosed with PCa in Norway from 2014 to 2017, a team led by Tyler M. Seibert, MD, PhD, of the University of California San Diego, found that the absolute incidence of high-risk disease among men aged 75 to 79 years is more than 6 times greater than that of men aged 55 to 59 years. Findings suggest that some healthy older men “could plausibly benefit from screening because of their high risk of aggressive disease and otherwise good life expectancy.”
“Efforts to optimize PCa screening for the efficient detection of potentially lethal localized disease should account for this strong age dependence,” Dr Seibert and his colleagues concluded.
The study demonstrated that the proportions of men diagnosed with Gleason 8 to 10 disease were 16.5%, 23.4%, 37.2%, and 59.9% among men aged 55 to 59, 65 to 69, 75 to 79, and 85 to 89 years, respectively. The proportions of men with at least high-risk disease in these age groups, respectively, were 29.3%, 39.1%, 60.4%, and 90.6%.
In addition, the maximum age-specific incidence rates (ASIRs), per 100,000 men, for low-risk, favorable intermediate-risk, unfavorable intermediate-risk, high-risk, regional, and metastatic disease were 157.1 for men aged 65 to 69 years, 183.8 for those aged 65 to 69 years, 194.8 for those aged 70 to 74 years, 408.3 for those aged 75 to 79 years, 159.7 for those aged 85 years or older, and 314 for those aged 85 years or older, respectively.
“Although our data suggest that screening older men may identify more clinically significant PCa, it is acknowledged that our data do not prove that screening could influence important clinical outcomes such as survival and quality of life,” the authors wrote.
Huynh-Le MP, Myklebust TÅ, Feng CH. Age dependence of modern clinical risk groups for localized prostate cancer—A population-based study [published online January 3, 2020]. Cancer.