Changes to screening protocols will drive a decreasing incidence of prostate cancer, says GlobalData
There has been a significant decline in prostate cancer incidence in recent years as changes have been made to screening protocols, but the number of cases continues to rise, according to GlobalData, a leading data and analytics company.
Actual cases of prostate cancer have increased, and diagnosed incident cases are forecast to rise in the seven major markets (7MM*) from 471,000 cases in 2016 to 548,500 in 2026, at an annual growth rate (AGR) of 1.67%.
The US will have the highest number of cases in 2026, with 186,000, growing at an AGR of 2.11%, followed by Japan with 116,500 cases and an AGR of 1.16%. No countries are expected to see a decrease in cases. GlobalData epidemiologists have attributed the increase in incident cases to male populations that are both growing and aging, as incidence is highest in men aged 65 and older.
In the US, prostate cancer is the most common cancer in men after skin cancer, and it is the third most common cause of cancer death in men. However, most of the cases are diagnosed at the age of 65 and older, and patients often live long enough that they die of other causes. Prostate cancer screening to detect early cancer is therefore questionable, as mortality and quality of life need to be balanced against overdetection and overtreatment.
The use of prostate-specific antigen (PSA) blood testing for prostate cancer screening has been widely debated. Prostate cancer survival is usually long, and early detection may not reduce the probability of dying from the condition. According to the study published this month in The Journal of the American Medical Association, a randomized controlled trial in the UK that compared a single PSA screening intervention versus standard practice without screening found no significant difference in prostate cancer mortality after a median follow-up of 10 years. The PSA screening, however, resulted in the increased detection of low-risk prostate cancer cases.
This study supports the expectations of GlobalData epidemiologists that incidence of prostate cancer will decrease with changes to screening protocols, but that there will be an increase in cases that can be attributed to the growing and aging population.
Prostate cancer screening has been controversial, and diagnosis in men who have not been affected by it – leading to unnecessary anxiety and treatment – is difficult to justify. There is therefore a specific need to develop and implement better strategies for diagnosing aggressive prostate cancers that need to be treated early.
* 7MM: US, France, Germany, Italy, Spain, UK, and Japan