Prostate cancer - UK incidence statistics

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, this has not been reflected in mortality rates. Much of the increase in incidence can be attributed to the incidental discovery of prostate cancers following transurethral resection of the prostate (TURP) and, more recently, the use of prostate specific antigen (PSA) testing.

In 2008, there were 37,051 new cases of prostate cancer diagnosed in the UK, that is around 101 men every day or one man every 15 minutes. Table 1.1 shows the numbers and rates of new cases in the UK and its constituent countries. 1-4 It has been estimated that the lifetime risk of being diagnosed with prostate cancer in 2008 is 1 in 9 for men in the UK.This was done using the Current probability method5

Table 1:1: Prostate Cancer (C61), Number of New Cases, Crude and European Age-Standardised (AS) Incidence Rates per 100,000 population, UK, 2008

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*95% LCL and 95% UCL are the 95% lower and upper confidence limits around the AS Rate

Prostate cancer risk is strongly related to age: very few cases are registered in men under 50 and around three-quarters of cases occur in men over 65 years. The largest number of cases is diagnosed in those aged 70-74 (Figure 1.1). 1-4

Figure 1.1: Prostate Cancer (C61), Average Number of New Cases per Year and Age-Specific Incidence Rates, UK, 2006-2008

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Prostate cancer incidence rates increase steeply with age and the highest rates occur in the 75-79 age group. For men aged 55-59 the incidence rate is 155 per 100,000 men; ten years later, at age 65-69, the rate more than triples to 510 per 100,000, and by 75-79 the rate is almost five times higher at 751 per 100,000. 

It is estimated from post-mortem data that around half of all men in their fifties have histological evidence of cancer in the prostate, which rises to 80% by age 80, but only 1 in 26 men (3.8%) will die from this disease 6,7 In other words, men are more likely to die with prostate cancer than from it - an important fact when considering population screening of asymptomatic men. 8,9

Section updated: 18/07/11

Nearly all prostate cancers are adenocarcinomas, mainly occurring in the peripheral zone of the prostate gland. 8

section updated 22/06/11

Deprivation incidence gradients with higher rates in the least deprived populations have been reported for both England & Wales and Scotland. 10-12,27 These deprivation gradients have widened during the 1990s due to the greater relative increase in incidence for men in the most affluent groups and are likely to be influenced by accessibility and uptake of PSA testing. 12

section updated 22/06/11

Worldwide, an estimated 899,000 men were diagnosed with prostate cancer in 2008, and more than two-thirds of cases are diagnosed in developed countries13  The highest rates are in Australia/New Zealand, Western, Northern Europe and Northern America, largely because the practice of prostate specific antigen (PSA) testing and subsequent biopsy has become widespread in those regions (Figure 1.2). 13,14

Figure 1.2: Prostate Cancer (C61), World Age-Standardised Incidence and Mortality Rates, World Regions, 2008 Estimates

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Within the USA there are also significant differences between racial groups. Prostate cancer incidence rates for black Americans are more than 50% higher than for white Americans while rates for Asian Americans are 40% lower than for white Americans. In 2001-2005 the age-standardised (to the 2000 US population) incidence rate was 249 per 100,000 for black men, 157 per 100,000 for white men and 94 per 100,000 for Asian men. 15

In 2008, around 324,000 men were diagnosed with prostate cancer in Europe (EU-27). 16 The lowest European rates are in southern and eastern Europe, and the highest rates are found in northern and western Europe ( Figure 1.3). 16

Figure 1.3: Prostate Cancer (C61), European Age-Standardised Incidence and Mortality Rates, EU-27 countries, 2008 Estimates

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A recent analysis of prostate cancer incidence and mortality within the UK and Ireland showed relatively little geographical variation. The availability and uptake of PSA testing across the country may have obscured the underlying variation in incidence. 17

section updated 18/07/11

Substantial increases in incidence have been reported in recent years for many countries around the world, including the UK. 18

Prostate cancer incidence trends for the UK are shown in Figure 1.4. In the UK, European age-standardised rates rose from 62 per 100,000 men in 1993 to 94 per 100,000 in 2001, an increase of 52%.  However, since 2001 the rates have only increased by 4% with the numbers of cases diagnosed rising from 32,624 to 37,051 in 2008.

Figure 1.4: Prostate Cancer (C61), European Age-standardised Incidence Rates, UK, 1993-2008

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Time trends for a longer period are shown in Figure 1.5 for Great Britain. Between 1975 and 2008 the number of cases in Great Britain more than quadrupled from 8,042 in 1975 to 36,089 in 2008. The rates have almost trebled from 33 per 100,000 in 1975 to 98 per 100,000 in 2008. 1-4  During the late 1970s and 1980s rates rose consistently, with an acceleration of the trend in the early 1990s followed by a brief levelling off in the mid-1990s and then another rising trend in the late 1990s. Over the same period prostate cancer mortality rates have remained relatively static.

Figure 1.5: Prostate Cancer (C61), European Age-standardised Incidence and Mortality Rates, Great Britain, 1975-2008

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Incidence trends by age group show a similar pattern but with a fall in the 85+ rate, beginning in the mid-1990s and then more steeply since 2001 (Figure 1.6).1-4

Figure 1.6: Prostate Cancer (C61), European Age-Standardised Incidence Rates, by Age, Great Britain, 1975-2008

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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) 19 and afterwards through the rising use of PSA testing (Figure 1.720). Prostate cancer was an incidental finding in the tissue removed by TURP in around 10% of men.

Figure 1.7: Prostate Cancer (C61), Age-Standardised Rates of Transurethral Resection of the Prostate and Crude Rate of PSA testing, Scotland 1981-96

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Analyses for other countries including the USA 21, 22 and Australia 23 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) 22 and it is estimated that more than half of US white men aged over 50 have had their PSA level tested. 14  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 much lower than in the USA. 24 In the UK it is estimated that between 5-6% of men over 40 have a PSA test each year. 25, 26

Section updated: 18/07/11

Prevalence data relate to those people in the UK population who were alive on a specific date having previously been diagnosed with cancer.

As the incidence of prostate cancer is high and five-year survival rates are around 70%, many men are alive who have been diagnosed with prostate cancer. There is an increase in prostate cancer prevalence which may be partially influenced by the introduction of TURP and PSA testing, consequently leading to the detection of a greater proportion of latent, earlier, slow growing tumours.

The latest analysis shows that on 31st December 2006, more than 181,000 men were alive up to ten years after being diagnosed with prostate cancer28. Table 1.2 shows the one, five and ten year prevalence for prostate cancer.

Table 1.2: Prostate Cancer (C61) Prevalence in the UK, at 31st December 2006

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section update 18/07/11