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Fatal prostate cancer incidence trends in the United States and England by race, stage, and treatment



Differential uptake of prostate-specific antigen testing in the US and UK has been linked to between-country differences for prostate cancer incidence. We examined stage-specific fatal prostate cancer incidence trends in the US and England, by treatment and race/ethnicity.


Using data from the National Cancer Institute’s Surveillance, Epidemiology, and End Results program and Public Health England’s National Cancer Registration and Analysis Service, we identified prostate cancer patients diagnosed between 1995 and 2005, aged 45–84 years. Fatal prostate cancer was defined as death attributed to the disease within 10 years of diagnosis. We used age–period–cohort models to assess trends in fatal prostate cancer incidence.


Fatal prostate cancer incidence declined in the US by −7.5% each year and increased in England by 7.7% annually. These trends were primarily driven by locoregional disease in the US and distant disease in England. Black men in both countries had twofold to threefold higher fatal prostate cancer incidence rates, when compared with their white counterparts; however, receipt of radical prostatectomy lessened this disparity.


We report a significant increasing rate of fatal prostate cancer incidence among English men. The black–white racial disparity appears pervasive but is attenuated among those who received radical prostatectomy in the US.

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Fig. 1: Age-specific fatal prostate cancer incidence rates by country and year of diagnosis, 1995–2005.
Fig. 2: Observed and forecasted fatal prostate cancer incidence in the United States and England, by stage at diagnosis.
Fig. 3: Observed and forecasted fatal prostate cancer incidence in the United States and England, by stage at diagnosis and receipt of radical prostatectomy (RP).
Fig. 4: Observed and forecasted fatal prostate cancer incidence in the United States and England by race.
Fig. 5: Observed and forecasted fatal prostate cancer incidence in the United States and England by race, stage, and receipt of radical prostatectomy (RP).


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The authors acknowledge and thank the teams at the National Cancer Institute’s Surveillance, Epidemiology, and End Results Program. Data for this study are based on information collected and quality assured by the PHE National Cancer Registration and Analysis Service. Access to the data was facilitated by the PHE Office for Data Release.

Author information




M.B.C., S.P.K., and E.N.B. conceived the work. E.N.B. and P.S.R. analysed the data. E.N.B. drafted the work. All authors revised the work critically and approved the final manuscript. The corresponding author attests that all listed authors meet authorship criteria.

Corresponding author

Correspondence to Eboneé N. Butler.

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NIH OHSRP determined that this research activity was exempt from IRB review per 45 CFR 46.

Data availability

The cancer registry data from the United States is available upon request to the Surveillance, Epidemiology, and End Results Program and can be reached at Inquiries for England’s cancer registration data can be made to Public Health England’s Office for Data Release at

Competing interests

The authors declare no competing interests.

Funding information

This work was supported by the Intramural Research Program of the Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD.

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Butler, E.N., Kelly, S.P., Coupland, V.H. et al. Fatal prostate cancer incidence trends in the United States and England by race, stage, and treatment. Br J Cancer 123, 487–494 (2020).

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