Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Epidemiology

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

Abstract

Background

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.

Methods

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.

Results

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.

Conclusions

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.

Access options

Rent or Buy article

Get time limited or full article access on ReadCube.

from$8.99

All prices are NET prices.

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).

References

  1. 1.

    Kelly, S. P., Rosenberg, P. S., Anderson, W. F., Andreotti, G., Younes, N., Cleary, S. D. et al. Trends in the incidence of fatal prostate cancer in the United States by race. Eur. Urol. 71, 195–201 (2017).

    Article  Google Scholar 

  2. 2.

    Epstein, M. M., Edgren, G., Rider, J. R., Mucci, L. A. & Adami, H. O. Temporal trends in cause of death among Swedish and US men with prostate cancer. J. Natl Cancer Inst. 104, 1335–1342 (2012).

    Article  Google Scholar 

  3. 3.

    Andriole, G. L. Serum prostate-specific antigen: the most useful tumor marker. J. Clin. Oncol. 10, 1205–1207 (1992).

    CAS  Article  Google Scholar 

  4. 4.

    Lu-Yao, G. L., Friedman, M. & Yao, S. L. Use of radical prostatectomy among Medicare beneficiaries before and after the introduction of prostate specific antigen testing. J. Urol. 157, 2219–2222 (1997).

    CAS  Article  Google Scholar 

  5. 5.

    Sheikh, K. & Bullock, C. Rise and fall of radical prostatectomy rates from 1989 to 1996. Urology 59, 378–382 (2002).

    Article  Google Scholar 

  6. 6.

    Collin, S. M., Martin, R. M., Metcalfe, C., Gunnell, D., Albertsen, P. C., Neal, D. et al. Prostate-cancer mortality in the USA and UK in 1975-2004: an ecological study. Lancet Oncol. 9, 445–452 (2008).

    Article  Google Scholar 

  7. 7.

    Martin, R. M., Donovan, J. L., Turner, E. L., Metcalfe, C., Young, G. J., Walsh, E. I. et al. Effect of a low-intensity PSA-based screening intervention on prostate cancer mortality: the CAP Randomized clinical trial. JAMA 319, 883–895 (2018).

    Article  Google Scholar 

  8. 8.

    Schroder, F. H., Hugosson, J., Roobol, M. J., Tammela, T. L., Ciatto, S., Nelen, V. et al. Screening and prostate-cancer mortality in a randomized European study. N. Engl. J. Med. 360, 1320–1328 (2009).

    Article  Google Scholar 

  9. 9.

    Andriole, G. L., Crawford, E. D., Grubb, R. L. 3rd, Buys, S. S., Chia, D., Church, T. R. et al. Mortality results from a randomized prostate-cancer screening trial. N. Engl. J. Med. 360, 1310–1319 (2009).

    CAS  Article  Google Scholar 

  10. 10.

    Etzioni, R., Penson, D. F., Legler, J. M., di Tommaso, D., Boer, R., Gann, P. H. et al. Overdiagnosis due to prostate-specific antigen screening: lessons from US prostate cancer incidence trends. J. Natl Cancer Inst. 94, 981–990 (2002).

    Article  Google Scholar 

  11. 11.

    Force, U. S. P. S. T., Grossman, D. C., Curry, S. J., Owens, D. K., Bibbins-Domingo, K., Caughey, A. B. et al. Screening for prostate cancer: US Preventive Services Task Force Recommendation Statement. JAMA 319, 1901–1913 (2018).

    Article  Google Scholar 

  12. 12.

    Patel, N. H., Bloom, J., Hillelsohn, J., Fullerton, S., Allman, D., Matthews, G. et al. Prostate cancer screening trends after United States Preventative Services Task Force Guidelines in an underserved population. Health Equity 2, 55–61 (2018).

    Article  Google Scholar 

  13. 13.

    Melia, J., Moss, S. & Johns, L. Contributors in the participating l. Rates of prostate-specific antigen testing in general practice in England and Wales in asymptomatic and symptomatic patients: a cross-sectional study. BJU Int. 94, 51–56 (2004).

    Article  Google Scholar 

  14. 14.

    Williams, N., Hughes, L. J., Turner, E. L., Donovan, J. L., Hamdy, F. C., Neal, D. E. et al. Prostate-specific antigen testing rates remain low in UK general practice: a cross-sectional study in six English cities. BJU Int. 108, 1402–1408 (2011).

    Article  Google Scholar 

  15. 15.

    Melia, J. & Moss, S. Survey of the rate of PSA testing in general practice. Br. J. Cancer 85, 656–657 (2001).

    CAS  Article  Google Scholar 

  16. 16.

    Hall, I. J., Tangka, F. K. L., Sabatino, S. A., Thompson, T. D., Graubard, B. I. & Breen, N. Patterns and trends in cancer screening in the United States. Prev. Chronic Dis. 15, E97 (2018).

    Article  Google Scholar 

  17. 17.

    Smittenaar, C. R., Petersen, K. A., Stewart, K. & Moitt, N. Cancer incidence and mortality projections in the UK until 2035. Br. J. Cancer 115, 1147–1155 (2016).

    CAS  Article  Google Scholar 

  18. 18.

    Jack, R. H., Davies, E. A. & Moller, H. Prostate cancer incidence, stage at diagnosis, treatment and survival in ethnic groups in South-East England. BJU Int. 105, 1226–1230 (2010).

    Article  Google Scholar 

  19. 19.

    Cook, M. B., Rosenberg, P. S., McCarty, F. A., Wu, M., King, J., Eheman, C. et al. Racial disparities in prostate cancer incidence rates by census division in the United States, 1999-2008. Prostate 75, 758–763 (2015).

    Article  Google Scholar 

  20. 20.

    Ben-Shlomo, Y., Evans, S., Ibrahim, F., Patel, B., Anson, K., Chinegwundoh, F. et al. The risk of prostate cancer amongst black men in the United Kingdom: the PROCESS cohort study. Eur. Urol. 53, 99–105 (2008).

    Article  Google Scholar 

  21. 21.

    National Cancer Institute, DCCPS, Surveillance Research Program. Surveillance, Epidemiology, and End Results (SEER) Program (www.seer.cancer.gov) SEER*Stat Database: Incidence - SEER 18 Regs Research Data, Nov 2017 Sub (1973-2015) <Katrina/Rita Population Adjustment> - Linked To County Attributes - Total U.S., 1969-2016 Counties. https://seer.cancer.gov/data-software/documentation/seerstat/nov2017/ (2018).

  22. 22.

    National Disease Registration Service. https://www.ndrs.nhs.uk/. (2018). Accessed 6 Dec 2018.

  23. 23.

    van Buuren, S. & Groothuis-Oudshoorn, K. mice: Multivariate imputation by chained equations in R. J. Stat. Softw. 45, 1–67 (2011).

    Article  Google Scholar 

  24. 24.

    Rubin, D. B. Multiple Imputation for Nonresponse in Surveys (John Wiley and Sons, New York, 1987).

    Book  Google Scholar 

  25. 25.

    Ahmad, O. B., Boschi-Pinto, C., Lopez, A. D., Murray, C. J. L., Lozano, R. & Inoue, M. Age Standardization of Rates: A New WHO Standard (World Health Organization, Geneva, 2001).

  26. 26.

    Kim, H. J., Fay, M. P., Feuer, E. J. & Midthune, D. N. Permutation tests for joinpoint regression with applications to cancer rates. Stat. Med. 19, 335–351 (2000).

    CAS  Article  Google Scholar 

  27. 27.

    Rosenberg, P. S. & Anderson, W. F. Age-period-cohort models in cancer surveillance research: ready for prime time? Cancer Epidemiol. Biomark. Prev. 20, 1263–1268 (2011).

    Article  Google Scholar 

  28. 28.

    Holford, T. R. The estimation of age, period and cohort effects for vital rates. Biometrics 39, 311–324 (1983).

    CAS  Article  Google Scholar 

  29. 29.

    Rosenberg, P. S. & Anderson, W. F. Proportional hazards models and age-period-cohort analysis of cancer rates. Stat. Med. 29, 1228–1238 (2010).

    PubMed  PubMed Central  Google Scholar 

  30. 30.

    Rosenberg, P. S., Barker, K. A. & Anderson, W. F. Estrogen receptor status and the future burden of invasive and in situ breast cancers in the United States. J. Natl Cancer Inst. 107, djv159 (2015)

  31. 31.

    Pashayan, N., Powles, J., Brown, C. & Duffy, S. W. Incidence trends of prostate cancer in East Anglia, before and during the era of PSA diagnostic testing. Br. J. Cancer 95, 398–400 (2006).

    CAS  Article  Google Scholar 

  32. 32.

    Moller, H., Fairley, L., Coupland, V., Okello, C., Green, M., Forman, D. et al. The future burden of cancer in England: incidence and numbers of new patients in 2020. Br. J. Cancer 96, 1484–1488 (2007).

    CAS  Article  Google Scholar 

  33. 33.

    Tikkinen, K. A. O., Dahm, P., Lytvyn, L., Heen, A. F., Vernooij, R. W. M., Siemieniuk, R. A. C. et al. Prostate cancer screening with prostate-specific antigen (PSA) test: a clinical practice guideline. BMJ 362, k3581 (2018).

    Article  Google Scholar 

  34. 34.

    Wallner, L., Frencher, S., Hsu, J. W., Loo, R., Huang, J., Nichol, M. et al. Prostate cancer screening trends in a large, integrated health care system. Perm. J. 16, 4–9 (2012).

    PubMed  PubMed Central  Google Scholar 

  35. 35.

    Sirovich, B. E., Schwartz, L. M. & Woloshin, S. Screening men for prostate and colorectal cancer in the United States: does practice reflect the evidence? JAMA 289, 1414–1420 (2003).

    Article  Google Scholar 

  36. 36.

    Etzioni, R., Gulati, R., Mallinger, L. & Mandelblatt, J. Influence of study features and methods on overdiagnosis estimates in breast and prostate cancer screening. Ann. Intern. Med. 158, 831–838 (2013).

    Article  Google Scholar 

  37. 37.

    Fleshner, K., Carlsson, S. V. & Roobol, M. J. The effect of the USPSTF PSA screening recommendation on prostate cancer incidence patterns in the USA. Nat. Rev. Urol. 14, 26–37 (2017).

    CAS  Article  Google Scholar 

  38. 38.

    Dess, R. T., Hartman, H. E., Mahal, B. A., Soni, P. D., Jackson, W. C., Cooperberg, M. R. et al. Association of black race with prostate cancer-specific and other-cause mortality. JAMA Oncol. 5, 975–983 (2019).

    Article  Google Scholar 

  39. 39.

    Paller, C. J., Wang, L. & Brawley, O. W. Racial inequality in prostate cancer outcomes-socioeconomics, not biology. JAMA Oncol. 5, 983–984 (2019).

    Article  Google Scholar 

Download references

Acknowledgements

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

Affiliations

Authors

Contributions

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.

Ethics declarations

Ethics approval and consent to participate

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 seertrack@imsweb.com. Inquiries for England’s cancer registration data can be made to Public Health England’s Office for Data Release at ODR@phe.gov.uk.

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.

Additional information

Note This work is published under the standard license to publish agreement. After 12 months the work will become freely available and the license terms will switch to a Creative Commons Attribution 4.0 International (CC BY 4.0).

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

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). https://doi.org/10.1038/s41416-020-0859-x

Download citation

Further reading

Search

Quick links