Overall stage at diagnosis
A high proportion (78-88%) of prostate cancer cases in England, Scotland and Northern Ireland have stage at diagnosis recorded.[1-3]
Prostate cancer patients diagnosed with a known stage are most commonly diagnosed at stage I in England (35%), stage II in Northern Ireland (39%) and stage IV in Scotland (34%).[1-3]
More prostate cancer patients with a known stage are diagnosed at an early stage (57-63% diagnosed at stage I or II) than a late stage (37-43% diagnosed at stage III or IV) in England and Northern Ireland.[1-3]
However, in Scotland more prostate cancer patients with a known stage are diagnosed at a late stage (44% diagnosed at stage III or IV) than an early stage (57% diagnosed at stage I or II).[1-3]
Between 17% and 34% of prostate cancer patients have metastases at diagnosis (stage IV).[1-3]
The stage distribution for each cancer type will reflect many factors including how the cancer type develops, the way symptoms appear, public awareness of symptoms, how quickly a person goes to see their doctor and how quickly the cancer is recognised and diagnosed by a doctor. It might also relate to whether a national screening programme that can detect early stage disease exists for that cancer type, along with the extent of uptake of that programme.
A cancer type associated with a large proportion of early stage diagnoses could be one that is more likely to be symptomatic at an earlier stage of development, with recognisable symptoms rather than more generic ones.
Prostate Cancer (C61), Proportion of Cases Diagnosed at Each Stage, All Ages, England 2014, Scotland 2013-2014, Northern Ireland 2010-2014
Stage at diagnosis by deprivation
Late stage at diagnosis of prostate cancer is associated with higher deprivation. Among adults aged 15-99 in England, 43% of those in the most deprived areas are diagnosed at stage III or IV, versus 38% of those in the least deprived areas.
Stage at diagnosis by age
Late stage at diagnosis of prostate cancer is more common in adults aged 80+ in England (56% diagnosed at stage III or IV), compared to those aged 60-79 (39% diagnosed at stage III or IV). And younger adults aged 15-59 (31% diagnosed at stage III or IV).
Late stage prostate cancer, is also more common in adults aged 60-79 (39% diagnosed at stage III or IV) versus those aged 15-59 (31% diagnosed at stage III or IV).
These patterns by deprivation, age and sex are probably not explained by other demographic differences.
Stage at diagnosis by ethnicity
Late stage at diagnosis for prostate cancer in England is less common in Black Caribbean adults (29% diagnosed at stage III or IV) and Asian Indian adults (30% diagnosed at stage III or IV), compared to White British adults (33% diagnosed at stage III or IV) after adjusting for age, sex and deprivation.
Variation in stage at diagnosis between countries and demographic groups might reflect variation in the use of prostate specific antigen (PSA) testing. PSA testing can lead to the diagnosis of early cancers that would never have gone on to cause harm in a man’s lifetime (overdiagnosis). This could lead to unnecessary treatment for some men, which can have serious side effects.
For example, there is evidence indicating that black men in the UK are more likely to have PSA tests compared with white men, with higher rates of PSA testing leading to an artificially higher proportion of early stage disease in this group.