April 5, 2024 – An “inevitable” global surge Prostate cancer comes, with global cases doubling to 2.9 million and deaths increasing by 85% to just about 700,000 by 2040, Thelancet The Prostate Cancer Commission warned this week.
At a gathering of urologists in Paris, the commission said the acceleration was already underway in high-income countries akin to the United States and the United Kingdom, but would gain momentum in low- and middle-income countries.
Nick James, MD, lead creator of Thelancet Report and professor of prostate and bladder cancer research on the Institute of Cancer Research in London, said the rise was partly a medical success story.
“Prostate cancer is, paradoxically, a problem rooted in biology. Men get prostate cancer as they get older,” James said.
“There is a sharp increase in high-income countries. But we will see a sharp increase in the number of 50-, 60- and 70-year-olds in poorer countries in the coming decades, and so will high-income countries such as the UK and the US smaller increase will be recorded.
The report will be presented on Saturday at the European Association of Urology 2024 Congress in Paris.
The report states: “The case for prostate cancer screening for all men aged 50 to 70 (and for all men of African descent aged 45 to 70) in high-income countries is strengthened by improved use of Technologies like MRI are becoming stronger and increasing.” Evidence for the protection of energetic surveillance.
Andrew Vickers, PhD, a biostatistician at Memorial Sloan Kettering Cancer Center in New York City, said COmmission got here to similar conclusions as he and a world research group in a single Strategy paper 2023. A significant gap, Vickers said, is the misuse of prostate-specific antigen (PSA) screening.
“We found that the pervasive political compromise of letting patients make their own decisions about PPE has led to the worst consequences of overuse in men who are unlikely to benefit from it, high rates of overdiagnosis and overtreatment, as well on economic and racial inequality,” Vickers said. “In our opinion, PSA screening should be done well – by implementing straightforward harm reduction strategies such as limiting screening in older men and using secondary testing before biopsy – or not at all.”
James said undertreatment of advanced disease was widespread; For example, only about 30-40% of men within the United States receive combination hormone therapy for metastatic disease. “Simply doing what we know works would improve outcomes,” he said.
James said men of African descent are twice as prone to develop prostate cancer, but whether treatment for these men should follow a special approach is unclear. The latest report highlighted the necessity to include more men of African descent in research.
Brandon Mahal, MD, deputy director of research in radiation oncology on the University of Miami Sylvester Comprehensive Cancer Center and co-author of the report, said latest approaches are needed to enable earlier diagnosis of prostate cancer in men in low- to middle-income countries, through which most patients develop metastases and are less prone to survive for long periods of time.
James really helpful pop-up clinics and mobile testing to encourage men who're at high risk of prostate cancer but feel well to detect deadly cancers early.
In England, for instance, James helped launch an outreach program called “The Man Van,” which provided free health checks, including PSA tests, to high-risk men in London.
“By bringing a van of quick and easy testing directly to men in the workplace and community, targeting those at higher risk of prostate cancer, we have conducted thousands of health screenings, resulting in nearly 100 cancer diagnoses in men, “I didn't see a doctor until the cancer had reached a more advanced stage,” he said.
He said the medical community worldwide was ill-prepared for the surge in prostate cancer cases.
“The solution cannot be to train more urologists, radiation oncologists, pathologists and radiologists because it just takes too long,” James said. However, increased use of nurses and artificial intelligence might be helpful. “In my own hospital, biopsies are a nurse-led and administered service. AI is already exceptionally good at diagnosis and will only get better,” he said.
Smartphones could also close gaps in poorer countries. “The same technology that enables facial recognition can already tell that it is a Gleason 7 prostate cancer,” James said, referring to the tool used to evaluate cancer development. “In countries like America, of course, it will not be introduced because the income of pathologists is at risk.”