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“Prostate Cancer of High Risk is Increasing”

Epidemiologic evidence indicates that more men are now presenting with higher-grade, more invasive prostate cancer in the wake of 2012 recommendations from the US Preventive Services Task Force (USPSTF) not to routinely screen asymptomatic patients to detect early disease. There has been a consistent, stepwise increase in cancers of higher Gleason score, as well as a stepwise increase in the median level of prostatic-specific antigen (PSA), in the 4 years after the USPSTF recommendations were released. At the same time, both surgical volume and the proportion of low-grade cancers have been dropping. Experts say, “Treating high-risk disease has its limitations, because you are not going to cure the majority of patients no matter what you do, so the better answer is to diagnose prostate cancer earlier.” They also say, “If our data are correct, the most important thing to do is to start screening more intensely again.” According to the American Cancer Society (ACS), in the United States, there will be nearly 61,360 new cases of prostate cancer diagnosed this year and about 26,730 deaths from the disease.

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