February 2, 2023
CHICAGO: After two decades of decline, rates of advanced prostate cancer are on the rise, causing concern among physicians and healthcare organizations around the nation. American College of Surgeons (ACS) experts are available to help the media and public understand this trend and offer guidance on how men can reduce their risk of developing advanced prostate cancer.
Recently, the American Cancer Society released its annual Cancer Facts & Figures report, noting that after years of decline, the incidence of prostate cancer increased by 3% per year from 2014 to 2019. According to the Society, this increase was driven in large part by the diagnosis of advanced-stage prostate cancer, which has increased by 4% to 5% annually. As a result, the proportion of men diagnosed with advanced prostate cancer has more than doubled.
Excluding skin cancer, prostate cancer is the most common cancer diagnosed in American men, and the second leading cause of cancer-related deaths in men, according to the Society.
The prostate-specific antigen (PSA) test—a blood test that detects levels of a protein made by cells in the prostate gland—can help detect abnormalities in the prostate. Guidelines on when to screen vary and may depend on a man’s family history or other factors.
There is some debate about when to get screened with the PSA test. ACS experts advise that the most important measure a man can take is to speak to his physician about risk factors for prostate cancer and to ask about screening with the PSA test. These days, the test can be combined with imaging techniques—when warranted—or close monitoring to avoid unnecessary biopsies or treatments.
James Eastham, MD, FACS, ACS Governor and Chief of Urology Service at Memorial Sloan Kettering Cancer Center: “I think there’s a misconception that all prostate cancers are slow-growing and won’t cause problems. That’s not true. Conversely, not all prostate cancers require treatment. I recommend asking your doctor about the PSA test. Over the years, we’ve gotten markedly better at using the PSA test to avoid unnecessary biopsies and treatment. I think there’s ample data that says PSA testing saves lives. There is also older, but ample data, saying that not all prostate cancers need to be treated. We now have the knowledge and tools to monitor men for prostate cancer based on risk. And for men diagnosed with prostate cancer, there are several treatment strategies available.”
Robert Brookland, MD, FACRO, FACR, Chair of the ACS American Joint Committee on Cancer and Chair of the Department of Radiation Oncology at Greater Baltimore Medical Center: “In my opinion, men starting at age 50 should get screened for prostate cancer, and if there’s a higher risk, for example, family history — father, brother or other first-degree relatives — then screening should occur earlier. Screening should include a PSA test, and in some cases, a digital rectal exam, which can find rectal or anal cancers as well. Prostate cancer is a very treatable disease, but our success rates are the best when we find it as early as we can.”
Photos courtesy of Memorial Sloan Kettering Cancer Center and Greater Baltimore Medical Center
The American College of Surgeons is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and improve the quality of care for all surgical patients. The College is dedicated to the ethical and competent practice of surgery. Its achievements have significantly influenced the course of scientific surgery in America and have established it as an important advocate for all surgical patients. The College has approximately 90,000 members and is the largest organization of surgeons in the world. "FACS" designates that a surgeon is a Fellow of the American College of Surgeons.