A new study reports significant increase in new cases of prostate cancer metastatic -
The number of new cases of metastatic prostate cancer rose 72 percent in the last decade 04-2013, reports a new study Northwestern Medicine. The report examines whether a recent trend of fewer men being screened can contribute to the rise, or if the disease became more aggressive -. Or both
The largest increase of new cases was among men 55 to 69 years, which increased 92 percent in the last decade. This increase is particularly troubling, the authors said, because men in this age group are expected to benefit most from screening for prostate cancer and early treatment.
In addition, the average PSA (prostate specific antigen) of men who have been diagnosed with metastatic prostate cancer in 2013 was 49, almost double that of men diagnosed in 04 with an average PSA 25, which indicates a greater extent of the disease at diagnosis.
The blood PSA level, a protein produced by cells of the prostate gland, is often higher in men with prostate cancer.
"One hypothesis is the disease became more aggressive, regardless of the screening change," said lead study author Dr. Edward Schaeffer, chair of urology at Northwestern University Feinberg School of Medicine and Northwestern Medicine. "the other idea is for screening guidelines have become more lax when men did diagnosed, it is at a more advanced stage of the disease. Probably both are true. We do not know for sure, but this is the subject of our current work. "
Schaeffer is also a member of the Lurie Comprehensive Cancer Center Robert H. Northwestern University.
document will be published July 19 in Prostate cancer and prostatic diseases , a journal of nature.
Schaeffer's research team analyzed information from the national database on cancer. It included 1,089 men 767.550 installations throughout the country who received diagnosed with prostate cancer between 04 and 2013.
during the last decade, there has been a substantial reduction in the number of men being prostate cancer screening and an associated decline total number of new cases of prostate cancer are reported.
"the fact that men in 2013 who had metastatic had PSA disease much higher than similar men in 04 suggests that more aggressive disease is on the rise, "said Schaeffer. "If I were a patient, I want to be careful. I firmly believe that PSA screening and rectal exams save lives."
If a patient is diagnosed with localized prostate cancer that is aggressive, treatment can be curative. If men have a metastatic prostate cancer, the treatments are not curative and only slow disease progression. Most patients with metastatic prostate cancer eventually die of the disease.
"There could be a significant increase in prostate cancer mortality rate if more people are diagnosed with metastatic disease, because treatments can slow the progression, it is not curable," said Schaeffer.
the study measured the number of cases of metastatic prostate cancer, not the effect, for example, cases per 100,000. in addition, metastatic disease began to increase in 08 before the change screening recommendations Preventive Services Task Force of the United States. Thus, investigators said, they can not definitively link the increase in cases of reduced screening alone.
Three percent those included in the study had metastases, which means that cancerous prostate cells had spread to other parts of their bodies by the time the cancer was diagnosed. the number of cases of metastatic prostate in 2013 (280) was 72 percent higher than in 04 (1,685). In middle-aged men 55 to 69 years, the number increased by 92 percent from 702 new cases in 04 to 1345 in 2013.
"The results indicate that the guidelines and the treatment screening must be refined based on each patient's risk factors and genetics, "said lead author Dr. Adam Weiner, a urology resident Feinberg. "This can help prevent the increasing occurrence of metastatic prostate cancer and potential death associated with the disease. This can also help reduce overdiagnosis and overtreating men with prostate cancer at low risk who do not require treatment."
"This will be especially critical for the economy of the health population in the United States, given the additional cost of care for metastatic prostate and an aging constituency whose population aged over 65 will double to over a projected 80 million by 2050, "Schaeffer said.
The largest increase of new cases was among men 55 to 69 years, which increased 92 percent in the last decade. This increase is particularly troubling, the authors said, because men in this age group are expected to benefit most from screening for prostate cancer and early treatment.
In addition, the average PSA (prostate specific antigen) of men who have been diagnosed with metastatic prostate cancer in 2013 was 49, almost double that of men diagnosed in 04 with an average PSA 25, which indicates a greater extent of the disease at diagnosis.
The blood PSA level, a protein produced by cells of the prostate gland, is often higher in men with prostate cancer.
"One hypothesis is the disease became more aggressive, regardless of the screening change," said lead study author Dr. Edward Schaeffer, chair of urology at Northwestern University Feinberg School of Medicine and Northwestern Medicine. "the other idea is for screening guidelines have become more lax when men did diagnosed, it is at a more advanced stage of the disease. Probably both are true. We do not know for sure, but this is the subject of our current work. "
Schaeffer is also a member of the Lurie Comprehensive Cancer Center Robert H. Northwestern University.
document will be published July 19 in Prostate cancer and prostatic diseases , a journal of nature.
Schaeffer's research team analyzed information from the national database on cancer. It included 1,089 men 767.550 installations throughout the country who received diagnosed with prostate cancer between 04 and 2013.
during the last decade, there has been a substantial reduction in the number of men being prostate cancer screening and an associated decline total number of new cases of prostate cancer are reported.
"the fact that men in 2013 who had metastatic had PSA disease much higher than similar men in 04 suggests that more aggressive disease is on the rise, "said Schaeffer. "If I were a patient, I want to be careful. I firmly believe that PSA screening and rectal exams save lives."
If a patient is diagnosed with localized prostate cancer that is aggressive, treatment can be curative. If men have a metastatic prostate cancer, the treatments are not curative and only slow disease progression. Most patients with metastatic prostate cancer eventually die of the disease.
"There could be a significant increase in prostate cancer mortality rate if more people are diagnosed with metastatic disease, because treatments can slow the progression, it is not curable," said Schaeffer.
the study measured the number of cases of metastatic prostate cancer, not the effect, for example, cases per 100,000. in addition, metastatic disease began to increase in 08 before the change screening recommendations Preventive Services Task Force of the United States. Thus, investigators said, they can not definitively link the increase in cases of reduced screening alone.
Three percent those included in the study had metastases, which means that cancerous prostate cells had spread to other parts of their bodies by the time the cancer was diagnosed. the number of cases of metastatic prostate in 2013 (280) was 72 percent higher than in 04 (1,685). In middle-aged men 55 to 69 years, the number increased by 92 percent from 702 new cases in 04 to 1345 in 2013.
"The results indicate that the guidelines and the treatment screening must be refined based on each patient's risk factors and genetics, "said lead author Dr. Adam Weiner, a urology resident Feinberg. "This can help prevent the increasing occurrence of metastatic prostate cancer and potential death associated with the disease. This can also help reduce overdiagnosis and overtreating men with prostate cancer at low risk who do not require treatment."
"This will be especially critical for the economy of the health population in the United States, given the additional cost of care for metastatic prostate and an aging constituency whose population aged over 65 will double to over a projected 80 million by 2050, "Schaeffer said.
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