1 in 7 boys born in 2015 will be diagnosed with prostate cancer during his lifetime, compared with 1 in 20 in 1990, according to the latest figures from Cancer Research UK, who suggest the main reason is the increased use of the PSA test, plus the fact men are living longer.
But against this backdrop is the good news that deaths to the disease are falling: in the last 20 years they have dropped by 18%.
The charity released their latest figures on Wednesday.
Professor Malcolm Mason, prostate cancer expert for Cancer Research UK, says in a statement:
“We’re detecting more cases of prostate cancer than ever before. And we’re carrying out an intensive amount of research to find better methods than PSA to distinguish between the minority of cases that are life threatening and do need treatment – the vipers – from the majority of cases that don’t – the grass snakes. But there is much more to be done.”
The Prostate Specific Antigen Test (PSA), which can be done at a GP surgery, measures blood levels of prostate-specific antigen, a protein produced by cells in the prostate gland.
Blood PSA levels tend to be higher in men with prostate cancer.
The test is used to diagnose a wide range of prostate cancers, including those that will never be life-threatening, as well as more aggressive types. Unfortunately, the test can’t tell the difference.
As more and more men have undergone PSA testing, so the numbers diagnosed with prostate cancer have risen.
Today, about 41,000 men a year are diagnosed with prostate cancer in the UK, around 15,000 more than 25 years ago.
But the rise in diagnoses is not just because more men are having the PSA test.
Cancer Research UK say another reason is because men are living longer, and men’s chances of developing prostate cancer are much higher when they are older.
Meanwhile, the chances of surviving prostate cancer in the UK are going up. In the period 1989 to 1991, the death rate from prostate cancer was 28.9 men per 100,000. The latest figures, for 2008 to 2010, put this at 23.8 per 100,000, a drop of 18%.
The most likely reason for this drop is earlier diagnosis, which increases chances of survival, and improved treatments.
Since the 1990s, there has been more widespread and earlier use of hormone treatments for prostate cancer, and these are improving all the time.
Newer treatments are beginning to show even better results in the survival rates. One example is abiraterone in patients with advanced prostate cancer. It was approved for use in May 2012.
There is currently a debate on whether all men should receive the PSA test. One of the problems is because the test can’t distinguish between aggressive and non-aggressive prostate cancers, it can lead to some men having radical treatment, which is of itself risky and has side effects, when they don’t need it.
Harpal Kumar, chief executive of Cancer Research UK, says:
“We need to build on the great progress already made and develop more targeted treatments for those men whose disease is life-threatening. We also need to develop better tests that will help us to know when to leave harmless forms of the disease alone.”
Mason says:
“Targeting the tests at men who have a higher risk of developing prostate cancer might be a better approach than screening all men.”
“Surgery and radiotherapy – with their potential side effects – is one option, to be balanced against the option of careful monitoring with regular checkups,” he adds.
A recently published study found that taking several PSA measurements over a period of time may improve the accuracy of aggressive prostate cancer detection compared to a single measurement.
Scientists at Cancer Research UK are working on a potential new test for prostate cancer that uses a protein called MSMB (Beta- microseminoprotein). They suggest a MSMB test might be better at identifying the higher risk prostate cancers. But more work needs to be done before they can be sure of its value.
Click here for the latest statistics on prostate cancer from Cancer Research UK.
Written by Catharine Paddock PhD