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10 times as many prostate cancers in 2021?

MANAGED CARE May 2011. © MediMedia USA
Managed Care Outlook

10 times as many prostate cancers in 2021?

MANAGED CARE May 2011. ©MediMedia USA

Canadian researchers say there could be as many as 267,329 new cases of prostate cancer diagnosed each year by 2021. That would be 10 times as many as in 2009 (25,355 cases).

Researchers in the department of radiation oncology at the Sunnybrook Health Sciences Center at the University of Toronto calculated prostate cancer cases using best-, most likely-, and worst-case scenarios.

“The trends we’re anticipating in Canada are going to be very similar to the United States,” says Andrew Loblaw, MD, lead author. He’s a staff radiation oncologist and clinician scientist at the center.

“For clinical executives, this would mean about 650,000 men diagnosed in the United States. So there’s going to be the need for increased capacity to diagnose these men. You’re going to need better quality in active surveillance. You’re going to have to increase your treatment capacity — both surgery and radiation. And lastly, it’s about cost. Both countries are struggling to effectively manage those health care dollars,” he says.

The four factors likely to affect the incidence of prostate cancer are an increase in the aging population, increased prevalence of PSA screening, lowered PSA cutoff to recommend biopsy, and improved sensitivity to prostate biopsy. Of the four factors, the aging population and the possible lowering of the PSA threshold before biopsy are expected to be the major influencers in new cases.

The U.S. Centers for Disease Control and Prevention makes no such predictions. Jun Li, MD, PhD, MPH, an epidemiologist at the CDC, says the latest data available for prostate cancer incidence are from 2006. The agency reports that the incidence of prostate cancer has decreased significantly, by 2.4 percent per year from 2000 to 2006.

With better screening, physicians are better equipped at finding prostate cancer earlier, and plotting an effective treatment plan. Loblaw points out that the “men who died this year from prostate cancer were diagnosed 17 years ago. And those men who are diagnosed today are going to have markedly different treatments, so these men will have different mortality rates 17 years from now.”

Three prostate cancer scenarios played out — Canada / Common cancers in men

Source: Quon H, Loblaw A, Nam R. Dramatic increase in prostate cancer cases by 2021. BJUI. Apr 20. doi: 10.1111/j.1464-410X.2011.10197.x. [Epub ahead of print]

Source: Centers for Disease Control and Prevention. United States Cancer Statistics. 2007