Trends in United States prostate cancer incidence rates by age and stage, 1995-2012
A partir des données des registres américains des cancers, cette étude analyse l'évolution de l'incidence du cancer de la prostate, en fonction de l'âge du patient (50-69 ans, ou 70 ans et plus) et du stade de la maladie, sur la période 1995-2012
Background: The advent of PSA testing in the late 1980s substantially increased prostate cancer incidence rates. Concerns about overscreening and overdiagnosis subsequently led professional guidelines (circa 2000 and later) to recommend against routine PSA testing. We evaluated trends in prostate cancer incidence, including late-stage diagnoses, from 1995 through 2012. Methods: We used joinpoint regression analyses to evaluate all-, localized/regional-, and distant-stage prostate cancer incidence trends based on Surveillance, Epidemiology, and End Results (SEER) data. We stratified analyses by age (50-69, 70+). We reported incidence trends as annual percent change (APC). Results: Overall age-adjusted incidence rates for localized/regional stage PCa have been declining since 2001, sharply from 2010 to 2012 (APC -13.1, 95% CI -23.5 to -1.3). Distant-stage incidence rates have declined since 1995, with greater declines from 1995 to 1997 (APC - 8.4, 95% CI -2.3 to -14.1) than from 2003 to 2012 (APC - 1.0, 95% CI -1.7 to -0.4). Distant-stage incidence rates declined for men 75+ from 1995 to 2012, but increased in men 50-69 from 2004 to 2012 (APC 1.7, 95% CI 0.2 to 3.2). Conclusions: Guidelines discouraging routine prostate cancer screening were temporally associated with declining localized/regional prostate cancer incidence rates; however, incidence rates of distant-stage disease are now increasing in younger men. Impact: This trend may adversely affect prostate cancer mortality rates.