The incidence rates of metastatic prostate cancer (mPCa) have increased significantly and coincide with the U.S. Preventive Services Task Force (USPSTF) recommendations against prostate cancer screening, according to a study published online March 14 in JAMA Network Open.
Mihir M. Desai, M.D., from University of Southern California in Los Angeles, and colleagues used the Surveillance, Epidemiology, and End Results database (SEER; 2004 through 2018) to identify 836,282 patients with prostate cancer. Incidence trends of mPCa were examined for before and after USPSTF recommendations against routine prostate cancer screening.
The researchers found that among men aged 45 to 74 years, the incidence rate of distant mPCa (SEER Summary staging) remained stable from 2004 to 2010 (annual percentage change [APC], −0.4 percent; 95 percent confidence interval [CI], −1.7 to 1.1 percent; P = 0.60), but increased significantly from 2010 to 2018 (APC, 5.3 percent; 95 percent CI, 4.5 to 6.0 percent; P < 0.001). The incidence rate of distant mPCa decreased from 2004 to 2011 among men ≥75 years (APC, −1.5 percent; 95 percent CI, −3.0 to 0 percent; P = 0.046), and then increased from 2011 to 2018 (APC, 6.5 percent; 95 percent CI, 5.1 to 7.8 percent; P < 0.001). The increases in mPCa incidence were particularly significant in non-Hispanic White men (2010-2018 APC, 6.9 percent; 95 percent CI, 5.4 to 8.4 percent; P < 0.001).
“This study suggests that the incidence of mPCA is increasing and might be temporally associated with changes in clinical policy and/or practice (e.g., USPSTF guidelines), which may explain such rapid changes in cancer epidemiological trends,” the authors write.
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