Prostate cancer incidence statistics

Prostate cancer is the most common cancer in men in the UK (2012), accounting for 25% of all new cases of cancer in males.[1-4] In 1990, both lung and bowel cancers were more common in males than prostate cancer, but by 1998 prostate cancer was the most common cancer in UK males.

In 2012, there were 43,436 new cases of prostate cancer in males in the UK.[1-4] The crude incidence rate Open a glossary item shows that that there are 139 new prostate cancer cases for every 100,000 males in the UK.

The European age-standardised incidence rate Open a glossary item (AS rate) is significantly lower in Scotland, compared with the other constituent countries of the UK, and lower in Northern Ireland, compared with England and Wales.[1-4]

Prostate Cancer (C61), Number of New Cases, Crude and European Age-Standardised (AS) Incidence Rates per 100,000 Population, Males, UK, 2012

England Wales Scotland Northern Ireland UK
Cases 37,136 2,419 2,857 1,024 43,436
Crude Rate 141.0 160.2 110.9 114.5 138.7
AS Rate 174.7 176.7 130.8 156.5 170.8
AS Rate - 95% LCL 172.9 169.7 126.0 146.9 169.2
AS Rate - 95% UCL 176.5 183.8 135.6 166.1 172.4

95% LCL and 95% UCL are the 95% lower and upper confidence limits Open a glossary item around the AS rate Open a glossary item

ASR calculated with ESP2013. Not comparable with ASRs calculated with ESP1976.

The latest analysis of prostate cancer incidence rates throughout the UK shows that in England now, as in the 1990s, there is little geographical variation in prostate cancer incidence: rates are lowest in the north, and higher than average in many parts of London and the south.[5-7] In Scotland, rates are highest in the south-east; and in Wales there is little variation between regions.[6,7]

References

  1. Data were provided by the Office for National Statistics on request, July 2014. Similar data can be found here: http://www.ons.gov.uk/ons/rel/vsob1/cancer-statistics-registrations--england--series-mb1-/index.html.
  2. Data were provided by ISD Scotland on request, April 2014. Similar data can be found here: http://www.isdscotland.org/Health-Topics/Cancer/Publications/index.asp.
  3. Data were provided by the Welsh Cancer Intelligence and Surveillance Unit on request, April 2014. Similar data can be found here:http://www.wales.nhs.uk/sites3/page.cfm?orgid=242&pid=59080.
  4. Data were provided by the Northern Ireland Cancer Registry on request, June 2013. Similar data can be found here: http://www.qub.ac.uk/research-centres/nicr/.
  5. Quinn M, Wood H, Cooper N, Rowan S, eds. Cancer Atlas of the United Kingdom and Ireland 1991–2000. Studies on Medical and Population Subjects No. 68. London: ONS; 2005.
  6. NCIN. Cancer Incidence and Mortality by Cancer Network, UK, 2005. London: NCIN; 2008.
  7. NCIN. Cancer e-Atlas. Accessed January 2013.
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Prostate cancer incidence is strongly related to age, with the highest incidence rates being in older men. In the UK between 2010 and 2012, an average of 36% of cases were diagnosed in men aged 75 years and over, and only 1% were diagnosed in the under-50s.[1-4] Age-specific incidence rates rise sharply from around age 50-54, peak in the 75-79 age group, and subsequently drop in the 80-84 age group, before increasing steadily to the 90+ age group. For men aged 55-59 the incidence rate is 168 per 100,000 men; in those 10 years older, at age 65-69, the rate more than triples to 559 per 100,000, and by 75-79 the rate is almost five times higher at 792 per 100,000. The slight drop in incidence rates in the oldest age groups may reflect less use of prostate specific antigen (PSA) Open a glossary item testing in men over 80.[5]

The age distribution of prostate cancer cases has changed over time: in 1979-1981, 46% of cases were diagnosed in men aged 75 and over in Great Britain, compared with 36% in 2010-2012 in the UK. This is probably largely due to the incidental discovery of early stage prostate cancers following transurethral resection of the prostate (TURP) Open a glossary item and, more recently, the use of PSA testing.[6]

Prostate Cancer (C61), Average Number of New Cases per Year and Age-Specific Incidence Rates, Males, UK, 2010-2012

ASR calculated with ESP2013. Not comparable with ASRs calculated with ESP1976.

References

  1. Data were provided by the Office for National Statistics on request, July 2014. Similar data can be found here: http://www.ons.gov.uk/ons/rel/vsob1/cancer-statistics-registrations--england--series-mb1-/index.html.
  2. Data were provided by ISD Scotland on request, April 2014. Similar data can be found here: http://www.isdscotland.org/Health-Topics/Cancer/Publications/index.asp.
  3. Data were provided by the Welsh Cancer Intelligence and Surveillance Unit on request, April 2014. Similar data can be found here:http://www.wales.nhs.uk/sites3/page.cfm?orgid=242&pid=59080.
  4. Data were provided by the Northern Ireland Cancer Registry on request, June 2014. Similar data can be found here: http://www.qub.ac.uk/research-centres/nicr/.
  5. Williams N, Hughes LJ, Turner EL, et al. Prostate-specific antigen testing rates remain low in UK general practice: a cross-sectional study in six English cities. BJU Int 2011;108(9):1402-8.
  6. Brewster D, Fraser L, Harris V. Rising incidence of prostate cancer in Scotland: increased risk or increased detection? BJU International 2000; 85: 463-473.
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Substantial increases in incidence have been reported in recent years for many countries around the world, including the UK.[1,2] Much of the increase in incidence both in the UK and in many other countries worldwide can be attributed to incidental detection of prostate cancers following TURP Open a glossary item and PSA Open a glossary item testing.[2,3]

Prostate cancer incidence rates have increased overall in Great Britain since the late-1970s.[4-6] European age-standardised Open a glossary item (AS) incidence rates more than doubled (147% increase) between 1979-1981 and 2010-2012. This overall rise comprises periods of particularly rapid increase during the early 1990s (41% increase between 1989-1991 and 1994-1996) and early 2000s (26% increase between 1997-1999 and 2002-2004); these periods correspond with the introduction of PSA testing from the late 1980s,[7-9] and with increasing rates of PSA testing around the late 1990s.[10,11] Recruitment to the CAP arm of the ProtecT trial in the early 2000s, in which men aged 50-69 were randomised to receive PSA testing in primary care, may also have contributed to the increase.[12]

Prostate Cancer (C61), European Age-Standardised Incidence Rates, Males, Great Britain, 1979-2012

ASR calculated with ESP2013. Not comparable with ASRs calculated with ESP1976.

Over the last decade (between 2001-2003 and 2010-2012), the European AS incidence rates have increased by 5% in the UK.[3-6,13]

Prostate Cancer (C61), European Age-Standardised Incidence Rates, Males, UK, 1993-2012

ASR calculated with ESP2013. Not comparable with ASRs calculated with ESP1976.

Prostate cancer incidence rates have increased overall for all of the broad age groups in Great Britain since the late-1970s.[3-6] The largest increase has been in men aged 25-49, with European AS incidence rates increasing more than eight-fold between 1979-1981 and 2010-2012, though rates remain relatively low at around 4 per 100,000 men. The rapid increase during the early 1990s (thought to be largely attributable to the introduction of PSA testing) was most pronounced for the 50-59 and 60-69 age groups, with increases of 76% and 58%, respectively, between 1989-1991 and 1994-1996. Rates have continued to rise for the 50-59, 60-69 and 70-79 age groups, but for men aged 80+, rates have decreased since the early 2000s, dropping by 21% between 2002-2004 and 2010-2012. This may be due to diagnosis of early prostate cancers in younger men through PSA testing, leaving increasingly fewer cases which have not yet been diagnosed by the time men reach their 70s and 80s.[14]

Prostate Cancer (C61), European Age-Standardised Incidence Rates, by Age, Males, Great Britain, 1979-2012

ASR calculated with ESP2013. Not comparable with ASRs calculated with ESP1976.

Analyses of prostate cancer incidence trends in Scotland, the US, Australia, Northern Ireland and the Republic of Ireland indicate that increased detection through TURP Open a glossary item and PSA Open a glossary item testing is implicated in the apparent increases in incidence in those countries.[15-19]

It is estimated that 75% of US men aged 50 years and older have had a PSA test.[20] In Europe, the level of population screening is much lower, with published estimates of 10-20%.[2]

References

  1. Hsing AW, Tsao L, Devesa SS. International Trends and Patterns of Prostate Cancer Incidence and Mortality. International Journal of Cancer (Pred.Oncol) 2000; 85:60-67.
  2. Bray F, Lortet-Tieulent J, Ferlay J, et al. Prostate cancer incidence and mortality trends in 37 European countries: an overview. Eur J Cancer 2010; 46:3040-52.
  3. Quinn M, Babb P. Patterns and trends in prostate cancer incidence, survival, prevalence and mortality. Part I: international comparison. BJU Int 2002; 90:162-73.
  4. Data were provided by the Office for National Statistics on request, July 2014. Similar data can be found here: http://www.ons.gov.uk/ons/rel/vsob1/cancer-statistics-registrations--england--series-mb1-/index.html.
  5. Data were provided by ISD Scotland on request, April 2014. Similar data can be found here: http://www.isdscotland.org/Health-Topics/Cancer/Publications/index.asp.
  6. Data were provided by the Welsh Cancer Intelligence and Surveillance Unit on request, April 2014. Similar data can be found here: http://www.wales.nhs.uk/sites3/page.cfm?orgid=242&pid=59080.
  7. Brewster D, Fraser L, Harris V. Rising incidence of prostate cancer in Scotland: increased risk or increased detection? BJU International 2000; 85: 463-473.
  8. Pashayan N, Powles J, Brown C, et al. Incidence trends of prostate cancer in East Anglia, before and during the era of PSA diagnostic testing. Br J Cancer 2006;95(3):398-400.
  9. UK National Screening Committee. Screening for Prostate Cancer. Review against programme appraisal criteria for the UK National Screening Committee (UK NSC). London: UKNSC; 2010.
  10. Melia J, Moss S. Survey of the rate of PSA testing in general practice. Br J Cancer 2001;85(5):656-7.
  11. Melia J, Coulson P, Johns L, et al. Report to the Department of Health. Study to assess the rate of PSA testing in men with no previous diagnosis of prostate cancer (Mapping of PSA testing: Part II). 2003.
  12. Lane JA, Hamdy FC, Martin RM, et al. Latest results from the UK trials evaluating prostate cancer screening and treatment: the CAP and ProtecT studies. Eur J Cancer 2010;46(17):3095-101.
  13. Data were provided by the Northern Ireland Cancer Registry on request, June 2014. Similar data can be found here: http://www.qub.ac.uk/research-centres/nicr/.
  14. Bray F, Lortet-Tieulent J, Ferlay J, et al. Prostate cancer incidence and mortality trends in 37 European countries: an overview. Eur J Cancer 2010; 46:3040-52.
  15. Potosky A, Kessler L, Gridley G, et al. Rise in Prostatic Cancer Incidence Associated with Increased Use of Transurethral Resection JNCI 1990; 82: 1624-1627.
  16. Potosky A, Miller BA, Albertsen PC, et al. The Role of Increasing Detection in the Rising Incidence of Prostate Cancer JAMA 1995: 273; 548-552
  17. Threlfall T, English D, Rouse I. Prostate Cancer in Western Australia: trends in incidence and mortality from 1985 to 1996 MJA 1998; 169: 21-24.
  18. Smith DP, Supramaniam R, Marshall VR, et al. Prostate cancer and prostate-specific antigen testing in New South Wales. Med J Aust 2008;189(6):315-8.
  19. Carsin AE, Drummond FJ, Black A, et al. Impact of PSA testing and prostatic biopsy on cancer incidence and mortality: comparative study between the Republic of Ireland and Northern Ireland. Cancer Causes Control 2010;21(9):1523-31.
  20. Sirovich BE, Schwartz LM, Woloshin S. Screening men for prostate and colorectal cancer in the United States: does practice reflect the evidence? JAMA 2003; 289:1414-1420.
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Staging completeness for prostate cancer is moderate in England, with 82% of prostate cancers recorded with a known stage at diagnosis in 2013.[1]

Prostate Cancer (C61), Proportion of Cases Diagnosed at Each Stage, England 2013

Males diagnosed with prostate cancer with a known stage most commonly present at stage I (36%), in England. More males with a known stage are diagnosed at an early stage (59% diagnosed at stage I or II) than an advanced stage (41% diagnosed at stage III or IV). Around 1 in 5 (20%) of males have metastases Open a glossary item at diagnosis (stage IV).[1]

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The lifetime risk of developing prostate cancer is 1 in 8 for men, in 2012 in the UK.[1]

The lifetime risk for prostate cancer has been calculated on the assumption that the possibility of having more than one diagnosis of prostate cancer over the course of a lifetime is very low (‘Current Probability’ method).[2]

References

  1. Lifetime risk estimates calculated by the Statistical Information Team at Cancer Research UK. Based on data provided by the Office of National Statistics, ISD Scotland, the Welsh Cancer Intelligence and Surveillance Unit and the Northern Ireland Cancer Registry, on request, December 2013 to July 2014.
  2. Esteve J, Benhamou E and Raymond L. Descriptive epidemiology. IARC Scientific Publications No.128, Lyon, International Agency for Research on Cancer, pp 67-68 1994.
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Prostate cancer is the most common cancer in Europe for males, and the third most common cancer overall, with around 417,000 new cases diagnosed in 2012 (3% of male cases and 12% of the total). In Europe (2012), the highest World age-standardised Open a glossary item incidence rates for prostate cancer are in Norway; the lowest are in Albania. UK prostate cancer incidence rates are estimated to be the 17th highest in Europe.[1] These data are broadly in line with Europe-specific data available elsewhere.[2]

Prostate cancer is the second most common cancer worldwide for males, and the fourth most common cancer overall, with more than 1,111,000 new cases diagnosed in 2012 (15% of male cases and 8% of the total). Prostate cancer incidence rates are highest in Australia/New Zealand and lowest in South Central Asia, but this partly reflects varying data quality worldwide.[1]

Variation between countries may reflect different prevalence of risk factors, use of screening, and diagnostic methods.

References

  1. Ferlay J, Soerjomataram I, Ervik M, et al. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet]. Lyon, France: International Agency for Research on Cancer; 2013. Available from:http://globocan.iarc.fr, accessed December 2013.
  2. Ferlay J, Steliarova-Foucher E, Lortet-Tieulent J, et al.Cancer incidence and mortality patterns in Europe: Estimates for 40 countries in 2012. European Journal of Cancer (2013) 49, 1374-1403.
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There is evidence for an association between prostate cancer incidence and deprivation in England, with prostate cancer being one of the few cancers where incidence rates are lower for more deprived males.[1] England-wide data for 2006-2010 show European age-standardised Open a glossary item incidence rates are 17% lower for males living in the most deprived areas compared with the least deprived.[1]

Prostate Cancer (C61), European Age-Standardised Incidence Rates by Deprivation Quintile, Males, England, 2006-2010

The estimated gap in prostate cancer incidence between males living in the most and least deprived areas in England has not changed in the period 1996-2010. It has been estimated that there would have been around 2,500 more prostate cancer cases each year in England during 2006-2010 if all males experienced the same incidence rates as the least deprived.[1]

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Age-standardised Open a glossary item rates for White males with prostate cancer range from 96.0 to 99.9 per 100,000. Rates for Asian males are significantly lower, ranging from 28.7 to 60.6 per 100,000 whereas the rates for Black males are significantly higher, ranging from 120.8 to 247.9 per 100,000.[1]

Ranges are given because of the analysis methodology used to account for missing and unknown data. For prostate cancer, 146,905 cases were identified; 37% had no known ethnicity.

There are similar differences by major ethnic group in the United States.[2] Black men may be diagnosed younger compared with white men, but factors around diagnosis do not fully explain the association between ethnicity and prostate cancer incidence.[3,4]

References

  1. National Cancer Intelligence Network and Cancer Research UK. Cancer Incidence and Survival by Major Ethnic Group, England, 2002-2006. 2009.
  2. Howlader NA, Krapcho M, Neyman N, et al, eds. SEER Cancer Statistics Review, 1975-2009 (Vintage 2009 Populations). Bethesda, MD: National Cancer Institute. Available from: http://seer.cancer.gov/csr/1975_2009_pops09/.
  3. Ben-Shlomo Y, Evans S, Ibrahim F, et al. The risk of prostate cancer amongst black men in the United Kingdom: the PROCESS cohort study. Eur Urol 2008;53:99-105.
  4. Metcalfe C, Evans S, Ibrahim F, et al. Pathways to diagnosis for Black men and White men found to have prostate cancer: the PROCESS cohort study. Br J Cancer 2008;99:1040-5.
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Prevalence refers to the number of people who have previously received a diagnosis of cancer and who are still alive at a given time point. Some patients will have been cured of their disease and others will not.

In the UK more than 181,000 men were still alive at the end of 2006, up to ten years after being diagnosed with prostate cancer.[1]

Prostate Cancer (C61) Prevalence in the UK, at 31st December 2006

1 Year Prevalence 5 Year Prevalence 10 Year Prevalence
Male 31,452 127,630 181,463

Worldwide, it is estimated that there were around 3.20 million men still alive in 2008, up to five years after their diagnosis.[2]

References

  1. National Cancer Intelligence Network (NCIN). One, Five and Ten Year Cancer Prevalence by Cancer Network, UK, 2006. London: NCIN; 2010.
  2. Ferlay J, Shin HR, Bray F, et al. GLOBOCAN 2008 v1.2, Cancer incidence and mortality worldwide: IARC CancerBase No. 10 [Internet]. Lyon, France: International Agency for Research on Cancer; 2010. Available from http://globocan.iarc.fr. Accessed May 2011.
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