Calls not to scale back PSA screening as prostate cancer rates fall

Jun 13, 2019
Calls not to scale back PSA screening as prostate cancer rates fall

Prostate-specific antigen (PSA) screening has been credited in cutting the number of people dying from prostate cancer in the United States.

Indeed, prostate cancer incidence and mortality rates have either decreased or stabilized in most parts of the world – with the biggest drop seen in the US, according to findings presented at the American Association for Cancer Research (AACR) annual meeting.

As the study’s lead author, MaryBeth Freeman, a senior associate scientist in surveillance research at the American Cancer Society, notes: “Previous studies have indicated significant variation in prostate cancer rates, due to factors including detection practices, availability of treatment, and genetic factors.

“By comparing rates from different countries, we can assess differences in detection practices and improvements in treatment.”

Freeman’s team used figures from the International Agency for Research on Cancer and the World Health Organization to analyze data from five continents.

In the US, it showed that prostate cancer incidence rates increased from the 1980s to the early 1990s, then declined from the mid-2000s through 2015.

Access to PSA screening

This was largely attributed to patterns of PSA screening, which is less available in lower-income nations where it contributes to later diagnosis and higher mortality rates, Freeman states.

However, she notes, some countries plan to scale back recommendations for the screening test; the argument being there is possible overtreatment of cancers that are unlikely to ever become symptomatic.

“Overall, patients should be having an informed discussion with their providers about the benefits and harms of PSA testing for detection of prostate cancer,” she advises.

“Future studies should monitor trends in mortality rates and late-stage disease to assess the impact of reduction in PSA testing in several countries.”

Overall, incidence data from 44 countries were analyzed. Researchers found that prostate cancer rates during the most recent five-year period increased in four countries, with the largest increase being seen in Bulgaria.

Prostate cancer rates down in 7 countries

The rates decreased in seven countries, with the United States at the top of the list. The 33 remaining countries saw stabilization of prostate cancer rates.

Mortality data from 71 nations were analyzed, showing a decrease in 14 countries, an increase in three and a stabilization in 54.

In the most recent five-year period studied, Brazil, Lithuania, and Australia had the highest incidence rates. The highest mortality rates were found in the Caribbean, specifically Barbados, Trinidad, Tobago, and Cuba, in addition to South Africa, Lithuania, Estonia and Latvia.

During the same period, India, Thailand, and Bahrain recorded the lowest incidence rates, while the lowest mortality rates were found in Thailand and Turkmenistan.

Freeman says she and her team are “surprised and pleased” to see so many nations achieving stabilization of prostate cancer rates.

However, as of 2012, it still remained the most commonly diagnosed cancer among men in 96 countries and the leading cause of death in 51.

In the coming years, Freeman speculates, global health experts hope that more nations will move from stability towards decreasing incidence and mortality rates.


Reference:

Prostate Cancer Incidence and Mortality Have Declined in Most Countries. (2019, April 2). Retrieved from https://cms.aacr.org/Newsroom/Pages/News-Release-Detail.aspx?ItemID=1308

 

Calls not to scale back PSA screening as prostate cancer rates fall

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