Prostate cancer in young men: An emerging young adult and older adolescent challenge

Abstract

Background Recent observations suggest that prostate cancer is an increasing disease among older adolescents and young adults. Methods Incidence, mortality, and survival data were obtained from the US National Cancer Institute Surveillance, Epidemiology, and End Results program and the Institute for Health Metrics and Evaluation Global Burden of Disease database. Results Worldwide, the incidence of prostate cancer has increased in all groups between ages 15 and 40 years and increased globally at a steady rate averaging 2% per year since 1990 (P < .01). In the United States, this age group was >6 times more likely than older men to have distant disease at diagnosis. Stage for stage, their survival rate improved less than in older men. Whereas the overall 5‐year relative survival rate in the United States for men diagnosed between ages 40 and 80 years was between 95% and 100%, it was 30% in those aged 15 to 24 years, 50% in those aged 20 to 29 years, and 80% in those aged 25 to 34 years. Conclusions Prostate cancer in older adolescent and young adult men has increased in most countries. There is some evidence that this may be caused in part by underdiagnosis, prostate‐specific antigen screening, and overdiagnosis. It also may be caused by trends in obesity, physical inactivity, HPV infection, substance exposure, environmental carcinogens, and/or referral patterns. How the biology of these cancers differs from that in older men and how the etiologies vary from country to country remain to be determined.

Putative Risk Factors of Prostate Cancer in Unscreened Ghanaian Men

“…We assert that the ability of our adjusted PSA cut off point of 10 ng/ml for prostate cancer to pick prostate cancer at an early age of 45 years in the study setting could be informative. Our data could support the view of a recent review study which suggested increasing high incidence of prostate cancer in younger men [27]. Our report feeding into reported low knowledge and awareness of prostate cancer risk in Ghana [28,29] call for the introduction an aggressive mass screening program to accurately detect the early detection age in the study setting.…”

Clinicopathological characteristics of localized prostate cancer in younger men aged ≤ 50 years treated with radical prostatectomy in the PSA era: A systematic review and meta‐analysis

“…2 However, autopsy study demonstrated that the prevalence of PCa between age 40 and 50 years was roughly 20%-30% in western cohorts, 3,4 and it was reported that the incidence of PCa between ages 15 and 40 years has increased steadily with a global averaging of 2% per year since 1990. 5 With the widespread use of prostate-specific antigen (PSA) screening, the incidence of PCa patients younger than 50 years increased by 5-fold during the last decades. 6 Considering longer life expectancy and fewer comorbidities, radical prostatectomy (RP) still remains as the standard treatment option for younger men with localized PCa.…”

Why is prostate cancer incidence rising in young men?

“…The article by Bleyer and colleagues in this issue of Cancer sheds new light on a curious phenomenon: prostate cancer incidence is rising in very young men. In their analyses, using several well respected databases (both global and US‐based), the number of men diagnosed with prostate cancer at age <40 years has approximately doubled since 1995.…”

“…In the United States, much of the increase in prostate cancer incidence among these young men occurred during the era of increasing prostate‐specific antigen (PSA) screening (1990‐2000), followed by a flattening of the incidence rates. In other parts of the world, where PSA screening has been less prevalent, the increase has been more linear over time …”

“…In other parts of the world, where PSA screening has been less prevalent, the increase has been more linear over time. 1 The etiology of the factors driving these underlying statistics are elusive. The authors have proposed various potential causes, but none of these are plausibly explored.…”