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Incidence of early-stage prostate cancer continues to decline after USPSTF recommendations
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The decline in incidence of early-stage prostate cancer following the U.S. Preventive Services Task Force’s recommendations against routine PSA testing persisted through 2013, according to a research letter published in JAMA Oncology.
However, the decline from 2012 to 2013 appeared smaller than the decline observed from 2011 to 2012.
Ahmedin Jemal
In 2011, the U.S. Preventive Service Task Force (USPSTF) issued draft recommendations against the routine use of PSA testing in all men, with the final USPSTF recommendation issued in 2012.
Ahmedin Jemal, DVM, PhD, vice president of surveillance and health services research at the American Cancer Society, and colleagues previously reported a notable decline in early-stage prostate cancer incidence rates in the period from 2011 to 2012.
In the current analysis, Jemal and colleagues evaluated whether the decline in incidence of early-stage prostate cancer persisted through 2013.
Researchers used 18 SEER registries — which represented approximately 28% of the U.S. population — to evaluate incidence data for invasive prostate cancer diagnoses in men aged 50 years or older between 2005 and 2013.
Researchers calculated delay-adjusted incidence rates by age ( 50 years, 50-74 years, 75 years), stage (all stages, locoregional, distant), and race or ethnicity (all races, non-Hispanic white, non-Hispanic black).
The incidence rate for locoregional prostate cancer significantly decreased from 2012 to 2013.
Among men aged 50 to 74 years, incidence rates per 100,000 men dropped from 356.5 in 2012 to 335.4 in 2013 (incidence ratio [IR] = 0.94; 99% CI, 0.92-0.96). Incidence rates also dropped from 379.2 to 353.6 (IR = 0.93; 99% CI, 0.89-0.97) among men aged 75 years or older.
Researchers noted these declines in incidence corresponded with previously reported declines in use of PSA screening. PSA testing rates significantly declined from 2010 to 2013 among men aged 50 years to 74 years (36.8% to 29.9%) and men aged 75 years or older (43.1% to 36.3%).
Incidence rates for distant-stage disease did not change during this time period among men aged 50 to 74 years (15.7 to 16.5) and men aged 75 years or older (65.8 to 66.4).
Similar rates of decreasing prostate cancer incidence occurred among non-Hispanic white men and non-Hispanic black men. The decline in early-stage prostate cancer among non-Hispanic black men did not reach statistical significance; however, the researchers acknowledged that this may be due to a lack of statistical power.
Overall, the decline in incidence rates for early-stage prostate cancer from 2012 to 2013 were smaller than those observed from 2011 to 2012 (6% vs. 19%).
“[T]he decrease in early-stage prostate cancer incidence rates from 2011 to 2012 in men 50 years and older persisted through 2013 in SEER registries, albeit at a slower pace,” Jemal and colleagues wrote. “Whether this pattern will lead to a future increase in the diagnosis of distant-stage disease and prostate cancer mortality requires long-term monitoring because of the slow-growing nature of this malignant neoplasm.” – by Cameron Kelsall
Disclosure: The researchers report no relevant financial disclosures.
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