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May 11, 2017

Declining Incidence Rates of Prostate Cancer in the United StatesIs This Good News or Not?

Author Affiliations
  • 1Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
  • 2Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
  • 3Department of Urology, Helen Diller Family Comprehensive Cancer Center, San Francisco, California
  • 4Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco
JAMA Oncol. Published online May 11, 2017. doi:10.1001/jamaoncol.2017.0470

Prostate cancer rates in the United States are down—sharply. According to the National Cancer Institute’s Surveillance, Epidemiology, and End Results Program (SEER),1 the age-adjusted rate was 112 prostate cancer diagnoses per 100 000 men in 2013, the most recent year with available data. This is a decline of 53% since 1992, when prostate-specific antigen (PSA) screening became widespread. This decrease is likely attributable to 2 factors. First, after more than 3 decades of widespread PSA screening to detect prostate cancer, there are few men with high PSA levels that haven’t already been diagnosed. Second, and perhaps more important, PSA screening is now becoming less common. In 2008, the US Preventive Services Task Force (USPSTF) advised against PSA screening for men older than 75 years. Screening then declined in all age groups. Recently, incidence declined dramatically, by more than 10% annually from 2010 to 2013. The 2013 prostate cancer incidence rate was the lowest since 1984, before PSA screening was used. With the 2012 USPSTF recommendation against screening for all age groups, further reductions in incidence rates are likely.

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