Increasing Incidence of Cancer of the Prostate

Abstract

Increased incidence of prostate cancer is likely a result of widespread use of prostate-specific antigen.

Diagnosis, management and screening of early localised prostate cancer.

“…It has been suggested that an unidentified carcinogen may be present in increasing amounts, although more likely reasons are the dramatic improvements in diagnostic equipment -particularly developments in PSA testing and needle biopsy, increased rates of transrectal resection of the prostate (TURP), and increased public awareness bringing more men forward for diagnosis. [6][7][8] It has been claimed that prostate cancer is a serious problem, but that it is mostly a disease of elderly men and has a relatively small impact on premature death. 9 It is often stated that men are more likely to die with prostate cancer than of it.…”

“…In the USA, prostate cancer is reported to be the most frequently diagnosed male malignancy, with between 84,889 7 and 132,000 23 new cases per year, and a lifetime risk of 9-11% of developing the disease. 8,23,24 It is estimated that some 32,000 men died of prostate cancer in the USA in 1991, with the disease being the second greatest cause of cancer death in men after lung cancer. 25 In 1993, the American Cancer Society predicted that there could be 165,000 new cases and 36,000 deaths from prostate cancer per year.…”

Epidemiology of Prostate Cancer

“…This increase occurred in all age groups, but the overall age-adjusted rise in incidence was primarily due to increases at older ages. Age-specific rates are shown in figure 3 [10], The age-adjusted incidence rates for prostate cancer among American blacks and [23], A recent analysis, however, has demonstrated a marked increase, particularly in the incidence of early stage disease, among American whites as compared with African-Americans [7,12], This increase was largely at tributed to a more frequent detection of the disease in younger patients. As well as personal and environmental causal factors [4,20,24,25], the more frequent use of transurethral resection (TUR) during the 1980s as com pared with the 1970s has led to an increased detection of unexpected tumour lesions (Tia or Tlb according to the TNM system) [26,27], Although the rate of TUR has now leveled off, other modes of detection have increased: annual prostate examinations by means of digital rectal examination, heightened patient awareness [24,28], se rum prostate-specific antigen (PSA) monitoring, and transrectal ultrasound needle biopsy [29][30][31].…”

The CAG trinucleotide repeat length in the androgen receptor does not predict the early onset of prostate cancer

“…Prostate cancer is the most common urological neoplasm diagnosed in men in the USA and Western Europe [1]; 30-40% of men aged ≈ 50 years are estimated to have histological evidence of cancer of the prostate, increasing to 70-80% of men aged ≥ 80 years [2]. Despite a high prevalence of subclinical prostate cancer in young men (50 years old) only ≈ 8% progress to clinically significant disease requiring treatment [3].…”