Startling cancer statistics

Categories: Summer/Fall 2023
P3A Colorado 6 Keebler Pass
©Sanford Radom, MD

Every 18 minutes a Black man is diagnosed with prostate cancer – the second leading cause of cancer death in Black men. In 2022, approximately 41,600 Black men were diagnosed that accounted for 37% of all new cancers among Black men. Approximately 1 in 6 Black men will be diagnosed with prostate cancer in their lifetime compared to 1 in 8 White men. 2014-2018, the average annual prostate cancer incidence rate was 172.6 cases per 100,000 among Black men, 73% higher than the rate among White men. The incidence rates increased sharply from 1989-1992 in both racial groups and then declined until the early 2010s, reflecting the U.S. Preventive Services Task Force’s (USPSTF) grade D recommendation against PSA screening for prostate cancer from 2010 to 2018, when it upgraded its recommendation for screening men aged 55-69 years after a shared decision-making counseling with a physician.

The incidence rates, reflecting largely localized-disease that accounts for a majority of cases remained relatively stable in both racial groups from 2014-2018; however, the rates for more advanced disease at diagnosis increased during this time by about 5% per year in both ethnic groups. The upturn in advanced disease likely reflects the reduction in PSA testing in the aftermath of the USPSTFs grade D recommendation.

Dr. Catalona, a member of the National Comprehensive Cancer Center (NCCN) Early Detection Guideline Panel on early prostate cancer, and was the first to demonstrate that the PSA test is the best first-line aid to the early detection of prostate cancer believes the guidelines should recommend PSA screening for men of average risk in their mid-40s (and beginning earlier for high-risk men, such as Black men, those with a strong family history of early-onset aggressive prostate cancer, or those who carry pathogenic genetic mutations, such as a BRCA2 gene mutation) and for healthy men aged 70 and older who are more likely to present with more aggressive disease. These views are generally represented in the NCCN’s recommended guidelines.

Siegel RL, et al, CA Cancer J Clin 2023, 73:17-48.

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