Contemporary Risk Profile of Prostate Cancer in the United States

Abstract

National-level data that characterize contemporary prostate cancer patients are limited. We used 2004-2005 data from the Surveillance, Epidemiology, and End Results Program to generate a contemporary profile of prostate cancer patients (N = 82 541) and compared patient characteristics of this 2004-2005 population with those of patients diagnosed in 1998-1989 and 1996-1997. Among newly diagnosed patients in 2004-2005, the majority (94%) had localized (ie, stage T1 or T2) prostate cancer and a median serum prostate-specific antigen (PSA) level of 6.7 ng/mL. Between 1988-1989 and 2004-2005, the average age at prostate cancer diagnosis decreased from 72.2 to 67.2 years, and the incidence rate of T3 or T4 cancer decreased from 52.7 per 100 000 to 7.9 per 100 000 among whites and from 90.9 per 100 000 to 13.3 per 100 000 among blacks. In 2004-2005, compared with whites, blacks were more likely to be diagnosed at a younger age (mean age: 64.7 vs 67.5 years, difference = 2.7 years, 95% confidence interval [CI] = 2.5 to 2.9 years, P < .001) and to have a higher PSA level at diagnosis (median PSA level: 7.4 vs 6.6 ng/mL, difference = 0.8 ng/mL, 95% CI = 0.6 to 1.0 ng/mL, P < .001). In conclusion, more men were diagnosed with prostate cancer at a younger age and earlier stage in 2004-2005 than in earlier years. The racial disparity in cancer stage at diagnosis has decreased statistically significantly over time.

Radical Prostatectomy versus Observation for Localized Prostate Cancer

“…The age, health status, PSA value, and tumor-risk characteristics of the men enrolled in this study were similar to those of both men who were eligible but declined to undergo randomization 9 and men in the general population who have received a diagnosis of prostate cancer. [1][2][3]8,29 Perioperative morbidity and mortality were similar to those previously reported. 28,30 The percentage of men with positive surgical margins was similar to that in earlier studies and lower than that in the SPCG-4 trial.…”

Patient Demographics, Quality of Life, and Disease Features of Men With Newly Diagnosed Prostate Cancer: Trends in the PSA Era

“…Although nonsignificant changes in CAPRA risk were observed for the overall cohort, academic sites had a decrease in low-risk decrease (68%-50%) and an increase in high-risk disease from 3%-19%. This finding contradicts the well-described downward stage migration of prostate cancer seen over the past several decades, 24,25 but may be related to several observed changes within academic sites, including increasing proportion of men diagnosed over age 65 and increasing rate of Gleason score 7 or higher on diagnostic biopsy. Academic sites also serve as large referral centers and increases in stage may be attributed to initial focal and nonsurgical treatment of low and intermediate risk disease.…”

Disproportionate Presentation of High Risk Prostate Cancer in a Safety Net Health System

“…1 has decreased with time, black men still present with prostate cancer at a younger age and higher stage. 14 Other studies revealed similar trends in the United States and Europe, although most were based on relatively homogenous populations with comparatively high socioeconomic status. 15 Mokete et al found a lack of stage migration in men from a inner city population in the United Kingdom who underwent PSA screening.…”