Prostate cancer incidence in US men <55 rose sharply until 2000-2009 then declined by 50% by 2020-22, while incidence in men ≥70 declined by over 50%.
Prostate cancer incidence has shifted toward younger onset over the past five decades in the US, with a peak in the early 2000s followed by a decline, highlighting the need to investigate emerging risk factors.
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354 Background: Prostate cancer (PC) epidemiology has undergone substantial transformation over the past three decades, influenced in part by the evolving USPSTF screening recommendations. We aim to characterize these temporal trends in PC incidence and mortality across age strata using Surveillance, Epidemiology, and End Results (SEER) and the Global Burden of Disease (GBD) databases. Methods: SEER provides case-reported, population-based cancer data covering 45.9% of the U.S. population, while GBD provides modeled estimates representing 100% national coverage. Using SEER from 1975 to 2022, age-standardized incidence rates (ASIR) and mortality rates (ASMR) per 100,000 were extracted with age, race, and stage stratification (Historic Stage A data; 1992–2019). Complementary GBD data for the U.S. were analyzed for age-specific incidence (ASpIR), mortality (ASpMR) and disability-adjusted life years (DALYs) (1990–2022). Results: In SEER, ASIR of PC increased sharply among young men (<55 years), peaking between 2000 and 2009 before declining by 2020–2022. Among men aged 45–49 years, ASIR increased from 5.6 (1975–1979) to 42 (2000–2009) before falling to 22 by 2020–2022. Among the 50–54 age group, ASIR rose from 24 to 148 and then declined to 102 over the same timeframe. Conversely, ASIR among men aged ≥70 years declined markedly after the 1990s peak (from 1,137 to 476 in ages 85–89). Localized-stage ASIR in men aged 50–54 years rose from 70 (1990–1999) to 133 (2000–2009), then fell to 63 (2010–2019), while distant-stage ASIR increased modestly from 2.7 to 4.0 before dropping subsequently. Black men aged 50–54 years exhibited a more pronounced growth in ASIR (from 50 to 234) than White men (24 to 91) with PC. Despite these shifts, ASMR for men aged 50–54 remained stable (4.7 in 1975–1979 vs. 4.9 in 2020–2022). GBD data echoed these trends, showing a 70% rise in ASpIR among men 20–54 (10 to 17) and a 17% decrease among men ≥55 (808 to 587) from 1990–2022. ASpMR decreased in older men (−43%) and remained stable in younger cohorts (−2%) over the same timeframe. DALYs showed similar age-related divergence (Table 1). Conclusions: PC incidence in younger men in the U.S. peaked in the early 2000s and declined thereafter, coinciding with the USPSTF’s 2012 recommendation against routine PSA screening and subsequent revisions in 2018. SEER data revealed persistent racial disparities among black young men with PC. Overall, PC incidence has increased markedly in men under 55 years over the past five decades, while it has declined substantially in older age groups. This epidemiological shift toward younger onset disease, warrants investigation into emerging risk factors and screening recommendations. Age stratified trends in prostate cancer in the US, 1990–2022 (GBD). GBD 20-54 (1990– 2022; % change) 55+ (1990– 2022; % change) ASpIR 10–17, 70% 808–587, -27% ASpMR 0.64–0.63, -2% 163–94, -43% DALY 33–37, -12% 3319–1879, -43%
Bhardwaj et al. (Sun,) reported a other. Prostate cancer incidence in US men <55 rose sharply until 2000-2009 then declined by 50% by 2020-22, while incidence in men ≥70 declined by over 50%.