by Prostate cancer cases worldwide are expected to double between 2020 and 2040, a new analysis suggests.
The data suggests that annual cases of prostate cancer are expected to rise from 1.4 million in 2020 to 2.9 million in 2040.
And annual deaths from the disease are expected to increase by 85% to nearly 700,000 over the same time frame, mainly among men in low- and middle-income countries (LMICs).
Due to aging populations and an increase in life expectancy there will be a higher number of elderly men in the coming years.
The main risk factors for prostate cancer – such as being aged 50 or over and having a family history of the disease – are unavoidable, so lifestyle changes will not be able to prevent the coming surge in cases lifestyle or public health interventions, the researchers. to be known.
The Lancet Commission on prostate cancer argues that the informed choice program for prostate cancer screening with testing, which is common in high-income countries (HICs), may lead to over-testing and unnecessary treatment in older men and under-testing. – risk of younger men.
Instead, the authors recommend early detection programs for those at high risk.
The Commission also calls for urgent programs to raise awareness of prostate cancer and improvements in early diagnosis and treatment in LMICs.
More research involving men of different ethnicities, particularly those of West African descent, is needed, the researchers say.
Prostate cancer is a major cause of death and disability, accounting for 15% of all cancers in men.
In the UK it is the second most common cause of cancer deaths in men and the most common form of cancer in more than half of the world’s countries.
Data suggests that there were an estimated 56,780 cases of prostate cancer in 2020 and this is expected to increase to 75,066 cases by 2040 (if incidence rates remain the same), a 32% increase over 20 years.
If there was a 1% reduction per year until 2040, as predicted for the Northern European region in the study, the predicted number in 2040 would still increase to 61,397 new cases, an increase of 8% over 20 years.
With a 1% annual increase in cases, the predicted number is 91,544 in 2040, a 61% increase over 20 years.
Nick James, lead author of the commission, Professor of prostate and bladder cancer research at the Institute of Cancer Research, London, said: “As more and more men around the world live into middle age and old age, there will be an increase inevitable on the number of those people. number of prostate cancer cases.
“We know this surge in cases is coming, so we need to start planning and taking action now.
“Evidence-based interventions, such as early detection and improved education programs, will help save lives and prevent ill health from prostate cancer in the years to come.
“This is especially true for low- and middle-income countries who will bear the brunt of future situations.”
In HICs, screening for prostate cancer often involves a PSA test, a blood test that measures levels of a protein called prostate-specific antigen (PSA).
The current approach to prostate cancer diagnosis in the UK and many other HICs relies on “informed choice” PSA testing.
Men age 50 or older who have no symptoms can request a PSA test from their doctor after discussing the risks and benefits.
According to the commission, there is evidence to suggest that this approach leads to over-testing among low-risk older men but does not increase detection of prostate cancer among younger, higher-risk men.
Instead, the authors recommend using MRI scanning in conjunction with PSA testing to screen men at high risk of prostate cancer in HICs.
This includes those with a family history of the disease, those of African descent and those with the BRCA2 mutation.
Experts say new approaches are needed to enable earlier diagnosis in LMICs, as most men in these countries present with an advanced form of the disease where the cancer has spread to other parts of the body. body, often the bones.
Men with late-stage prostate cancer are less likely to survive for a long time than those diagnosed early.
Professor James, who is a consultant clinical oncologist at the Royal Marsden NHS Foundation Trust, also said: “With prostate cancer we can’t wait for people to feel unwell and seek help – we need to encourage testing for those who feel well but who have a high level. the risk of the disease to catch fatal prostate cancer early.
“Pop-up clinics and mobile testing provide cost-effective solutions that combine health checks and education.”
The experts point out that a lack of trained staff and specialized facilities is a major barrier to improved prostate cancer care in LMICs.
Urgent measures are therefore needed to build surgical and radiotherapy capacity in these countries, they say.
Alfred Samuels, 66, is a black man who was diagnosed with stage 4 prostate cancer at the age of 54.
He said: “This report has been a long time coming.
“I wholeheartedly agree that we need a targeted approach to screening those at higher risk, like black men – this would be invaluable.
“Due to the late stage at which my prostate cancer was diagnosed, I wouldn’t be here today if I hadn’t been able to access a clinical trial – that was my masterpiece.
“Now, it must be mandatory to record ethnicity in clinical trials, and trials must reflect the ethnic diversity of the population, so we can get better treatments for people like me.”
The Commission will be launched at the 39th Annual Conference of the European Society of Urology on Saturday.
Cancer Research UK’s director of evidence and implementation, Naser Turabi, said: “This study highlights the impact of an aging, growing population on the increasing number of people diagnosed with prostate cancer worldwide. Here in the UK, cases have increased by around 150% in the last 25 years.
“We support the Lancet’s call for more research into early detection of prostate cancer. Cancer Research UK is funding a study to help us find ways to accurately diagnose the disease early, and we are also running trials to find the best treatment for men with prostate cancer.”
