Metastatic prostate cancer on the rise as cancer screenings decline

A new study from Keck Medicine at USC has found a significant increase in the incidence of metastatic prostate cancer in men 45 and older, in line with recommendations against routine prostate cancer screening

Mihir M.

Desai is also a professor of clinical urology at the Keck School of Medicine of USC and an associate member of the USC Norris Comprehensive Cancer Center (part of Keck Medicine)

Routine prostate-specific antigen (PSA) screening for prostate cancer began in the United States about 30 years ago

The introduction of screening has led to a decline in metastatic prostate cancer and prostate cancer mortality

In 2008, the U.

Prostate cancer screening in men declined after recommendations changed across all age groups and ethnic backgrounds, research shows

Researchers at Keck Pharmaceuticals wanted to assess trends in metastatic prostate cancer before and after the USPSTF opposed screening

Using the Surveillance, Epidemiology, and End Results (SEER) Program Cancer Incidence Database, they identified men 45 years of age and older diagnosed with invasive prostate cancer from 2004 to 2018

The SEER database recorded 836,000 prostate cancer patients over the age of 45 from 2004 to 2018

In the 45-74 age group, the incidence of metastatic prostate cancer remained stable from 2004-2010 and increased by 41% from 2010-2018

The researchers noted that these increases contrasted sharply with a downward trend in the incidence of metastatic prostate cancer between 2004 and 2009, before the U.

The authors also discuss the possibility that factors other than changes in screening recommendations in 2008 and 2012 may play a role in the increase in cancer cases, such as the use of new, advanced diagnostic and staging tools to better detect volume (minimally invasive) Metastatic prostate cancer

They concluded, however, that the technique is not widespread and typically not used for first-time cancer detection, so it is unlikely to be significant in the findings
.

"This data is important because it demonstrates the need to continually reassess the impact of policy decisions," said co-first author Jowa, research assistant professor of urology and radiology at Keck College and associate member at USC Norris.
said Giovanni Cacciamani
.
"Otherwise, we may see rates of metastatic prostate cancer continue to rise
.
"

The authors say that initial concerns about stopping screening -- which led to overdiagnosis and overtreatment of low-risk prostate cancer -- may also be outdated
.

"Excellent urology centers, including the USC Urology Department, are continually investigating ways to use technology to optimize patient outcomes and reduce the side effects of treatment,
" said Inderbir Gill, MD, Katherine and Joseph Aresti Urology Chair of the Department, Distinguished Professor of Urology at Keck, Executive Director of the USC Urology Institute and Member of USC Norris
.
"Fineer strategies, including biomarkers and magnetic resonance imaging, have increased detection of clinically significant cancers, while active surveillance is also increasingly used for low-risk and favorable intermediate-risk disease, reducing overtreatment risk
.
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