Since 1991, the U.S. cancer death rate has continued to decline, according to the American Cancer Society’s (ACS) annual statistics report. While this is excellent news that has saved an estimated 3.8 million American lives, unfortunately, after two decades of declines, prostate cancer deaths among U.S. men increased by 3% yearly from 2014 through 2019.
Prostate cancer is the second leading cause of death for men in the U.S. The ACS estimates that 288,300 men will be diagnosed with this disease in 2023. This estimate means that almost 20,000 more men will be diagnosed with prostate cancer than the number of me diagnosed with the disease in 2022. Higher rates of advanced prostate cancer drive most of this downturn in prostate cancer rates.
A particularly concerning finding was that black men have been and will continue to be primarily affected by the increase in prostate cancer. This annual statistics report from ACS stated that black men have a 70% higher risk of prostate cancer compared to white men.
Advanced prostate cancer diagnoses have also seen a 5% year-over-year increase which, means one thing: Men are not getting prostate cancer screenings to catch this disease at an earlier, more treatable stage. ACS officials stated this is likely from confusion and continued debate over screening guidelines.
There are two tests commonly used to screen for prostate cancer:
Both the PSA and DRE tests can be done at a doctor’s office, and both help screen for possible prostate cancer at an early stage. Finding prostate cancer at its earliest, most treatable stage can result in a 98-99% survival rate. Conversely, prostate cancer that has metastasized or spread beyond the prostate gland or is at a more advanced stage makes treatment more complex, with survival rates lower.
The PSA blood test can detect the amount of protein made by the prostate. Men with a high level of PSA in their blood may indicate prostate cancer but is not definitive proof as other factors can increase PSA levels, such as an enlarged prostate or prostatitis.
During a DRE exam, a doctor inserts a gloved finger into the rectum to feel for any lumps or bumps on the prostate gland. If anything unusual is found on the PSA or DRE tests, further testing may be required for an accurate diagnosis of prostate cancer.
The PSA and DRE can be done at a doctor’s office and both help detect prostate cancer at an early stage before it has metastasized or spread beyond the prostate gland, making treatment more difficult.
As a urologist oncologist with over 20 years of experience treating and taking care of men with prostate cancer, I recommend beginning at age 40 for men to have a baseline PSA test. In addition, any man with a family history of having their father or a brother diagnosed with prostate cancer or a female relative with breast cancer caused by the BRCA2 gene should absolutely begin at age 40. These men will be at a higher risk for not only developing prostate cancer but also with a higher risk of aggressive prostate cancer.
Men with an abnormal finding from a PSA or DRE exam, would benefit from a diagnostic technique called magnetic resonance imaging (MRI) fusion biopsy. MRI fusion biopsy provides a more accurate diagnosis for determination of prostate cancer. This tool has dramatically changed how we diagnosis prostate cancer and whether to go ahead and biopsy.
The other factor that needs to be addressed is reversing the differences between black men versus white men and prostate cancer diagnoses and death rates. The ACS has a plan called Improving Mortality from Prostate Cancer Together (IMPACT) to reduce death rates among black men by 2023. This plan includes improving education, new research programs, and a second look at prostate cancer screening guidelines.
With new diagnostic tools and efforts to reduce prostate cancer rates and mortality, the future of fighting this disease among men looks more promising.
Dr. David Samadi is the Director of Men’s Health and Urologic Oncology at St. Francis Hospital in Long Island. He’s a renowned and highly successful board certified Urologic Oncologist Expert and Robotic Surgeon in New York City, regarded as one of the leading prostate surgeons in the U.S., with a vast expertise in prostate cancer treatment and Robotic-Assisted Laparoscopic Prostatectomy. Dr. Samadi is a medical contributor to NewsMax TV and is also the author of The Ultimate MANual, Dr. Samadi’s Guide to Men’s Health and Wellness, available online both on Amazon and Barnes & Noble. Visit Dr. Samadi’s websites at robotic oncology and prostate cancer 911.