Cancer Research UK : UK Prostate Cancer incidence statistics

UK Prostate Cancer incidence statistics

This page presents UK prostate cancer incidence statistics by age , geographic variation, trends over time, histology and deprivation.The ICD code for prostate cancer is ICD9 185 and ICD10 C61.

Prostate cancer is the most common cancer in men in the UK – it accounts for nearly a quarter (24%) of all new male cancer diagnoses.

Although there has been a huge rise in prostate cancer incidence over the last 20 years, the increase in mortality has been much less. Much of the increase in incidence is due to the increased detection of prostate cancer through the use of prostate specific antigen (PSA) testing and surgery for benign prostatic hyperplasia (BPH).

In 2004, there were 34,986 new cases of prostate cancer diagnosed in the UK. Table 1.1 shows the numbers and rates of new cases in the UK and its constituent countries.1-4 The lifetime risk of being diagnosed with prostate cancer is 1 in 14 for men in the UK.5

Table 1.1: Number of new cases and rates of prostate cancer, by country, UK

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Prostate cancer incidence by age

Prostate cancer risk is strongly related to age: very few cases are registered in men under 50 and around 60% of cases occur in men over 70 years old. The largest number of cases is diagnosed in those aged 70–79 (Figure 1.1).1-4

Figure 1.1: Number of new cases and incidence rates by age, prostate cancer, UK

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Incidence rates increase steeply with age and the highest rates occur in the oldest age groups. For those aged 65–69 the incidence rate per 100,000 men is 494, by age 75–79 it is 764 and the rate rises to 853 by 85+.

It is estimated that 15–30% of men over 50 have histological evidence of cancer in the prostate rising to 60–70% by the age of 80, but only 1 in 25 men (4%) will die from this disease.6 In other words, men are more likely to die with prostate cancer than from it.

Geographic variation in prostate cancer incidence

Worldwide, more than 670,000 men are diagnosed with prostate cancer every year, accounting for one in nine of all new cancers in males. It is the second most common cancer in men after lung cancer.7

Recent incidence rates are heavily influenced by the availability of PSA testing in the population and incidence varies far more than mortality. The highest incidence rates are in the United States and Sweden and the lowest rates are in China and India (Figure 1.2).7 The extremely high rate in the USA (125 per 100,000) is more than twice the reported rate in the UK (52 per 100,000). This is likely to be due to the high rates of PSA testing in the USA.8

Figure 1.2: Age standardised (world) incidence rates, prostate cancer in selected countries, 2002 estimates

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Black American men have higher rates of prostate cancer than white American men: US SEER data for 1997–2002 reported age-adjusted incidence rates of 274 per 100,000 for black men compared with 171 per 100,000 for white men.9

A study of rates of prostate cancer mortality in Jewish American men found rates were significantly lower than non-Jewish white Americans.10

Around 306,369 cases are diagnosed each year in Europe. The lowest European rates are in southern and eastern Europe, while the highest rates are found in countries in Scandinavia and northern Europe (Figure 1.3).7

Figure 1.3: Age standardised (European) incidence and mortality rates, prostate cancer in EU countries, 2006 estimates

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Trends in prostate cancer incidence

Substantial increases in incidence have been reported in recent years for many countries around the world, including the UK.11

Figure 1.4 shows the European age-standardised incidence rates for Great Britain.12-14

Figure 1.4: Age standardised (European) incidence and mortality rates, prostate cancer, GB,

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During the 1980s these rates rose consistently, with an acceleration of the trend in the early 1990s followed by a brief levelling off in the mid-1990s and another rising trend in the late 1990s. Some of this increase may be due to a real increase in risk, but increasing detection of the disease has almost certainly played a part.

Figure 1.5 shows the prostate cancer incidence trend for the UK.

Figure 1.5: Age standardised (European) incidence rates, prostate cancer, males, UK, 1993-2004

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An analysis of prostate cancer incidence trends in Scotland concluded that much of the apparent increase in cancer incidence between 1981 and 1996 was caused by increased detection – before 1989 through increasing rates of transurethral resection of the prostate (TURP) and afterwards through the rising use of PSA testing (Figure 1.6).16

Figure 1.6: Age standardised rates of transurethral resection of the prostate and the crude rate of PSA testing, Scotland 1981-96

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Analyses for other countries including the USA and Australia17-19 have also pointed to increased detection being a factor.

In the USA widespread PSA testing on asymptomatic men from around 1986 resulted in dramatic increases in incidence (an 82% rise between 1986 and 1991) 20 and it is estimated that more than half of US white men aged over 50 have had their PSA level tested.8 In western Europe the widespread use of PSA tests began a few years later, in around 1989–1990, but the level of population screening is still thought to be much lower than in the USA.21 Cases may also be picked up at post-mortem, which most cancer registries will record.22

Whether there is a real increase in incidence or not, the numbers of cases of prostate cancer will rise as the population at risk (older men) expands due to increasing life expectancy. An increase has been seen in all age groups over 45 in Great Britain since the mid-1970s (Figure 1.7).2, 4, 23

Figure 1.7: Age-specific incidence rates, prostate cancer, GB, 1975-2004

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Histology of prostate cancer

Nearly all prostate cancers are adenocarcinomas, mainly occurring in the peripheral zone of the prostate gland. Benign prostate hyperplasia commonly arises in the central zone of the gland.

Deprivation and prostate cancer incidence

Deprivation incidence gradients have been reported in both England & Wales and Scotland, with higher rates in the least deprived populations.24,25 It is not known to what extent the incidence differences reflect true variation in risk by socio-economic group or differences in access to screening.

References

Northern Ireland Cancer Registry. Cancer Incidence and Mortality.2007
Welsh Cancer Intelligence and Surveillance Unit.2007
ISD Online Information and Statistics Division, NHS Scotland. 2007
Office for National Statistics, Cancer Statistics registrations:Registrations of cancer diagnosed in 2004, England Series MB1 no.35. 2007, London: National Statistics
Office for National Statistics, Health Statistics Quarterly Autumn 2000
Selley, S., et al., Diagnosis, management and screening of early localised prostate cancer Health Technol Assess, 1997. 1(2)
J. Ferlay, P. Autier, M. Boniol, M. Heanue, M. Colombet, P. Boyle. Estimates of the cancer incidence and mortality in Europe in 2006 Ann Oncol. 2007 Mar;18(3):581-92.
Gann, P, et al., Interpreting Recent Trends in Prostate Cancer Incidence and Mortality Epidemiology, 1997. 8: p. 117-119.
Ries, L.A.G., et al., SEER Cancer Statistics Review, 1975-2002, 2005, NCI: Bethesda, MD
Rodriguez, C., et al., Jewish ethnicity and prostate cancer mortality in two large US cohorts. Cancer Causes Control, 2002. 13(3): p. 271-7.
Hsing, A., L. Tsao, and S. Devesa,International Trends and Patterns of Prostate Cancer Incidence and Mortality International Journal of Cancer (Pred.Oncol), 2000. 85: p. 60-67
Office for National Statistics
ISD online
Welsh Cancer Intelligence and Surveillance Unit.
Horwich, A., J. Waxman, and F.H. Schroder, Tumours of the prostate, in Oxford Textbook of Oncology 1995,OUP: Oxford.
Brewster, D., et al.,Rising incidence of prostate cancer in Scotland: increased risk or increased detection? BJU International, 2000. 85: p. 463-473
Potosky, A., et al.,Rise in Prostatic Cancer Incidence Associated with Increased Use of Transurethral Resection JNCI, 1990. 82: p. 1624-1627.
Potosky, A., et al., The Role of Increasing Detection in the Rising Incidence of Prostate Cancer JAMA, 1995. 273: p. 548-552
Threlfall, T., D. English, and I. Rouse, Prostate Cancer in Western Australia: trends in incidence and mortality from 1985 to 1996 MJA, 1998. 169: p. 21-24.
Brawley, O., Prostate cancer incidence and patient mortality: the effects of screening and early detection Cancer, 1997. 80: p. 1857-1863
Levi, F., E. Negri, and S. La Vecchia, Recent Trends in Prostate Cancer Mortality in the European Union. Epidemiology, 2000. (11): p. 612
Coleman, M., et al., Trends in Cancer Incidence and Mortality. ed. IARC Scientific Publications, ed. Vol. 121. 1993, Lyon: IARC.
Cancer incidence and mortality data. 2005 ISD Online
Quinn, M., et al., Cancer Trends in England & Wales 1950-1999. Vol. SMPS No. 66. 2001: TSO.
Scottish Cancer Intelligence Unit, Trends in Cancer Survival in Scotland 1971-1995 Vol. 2000