UK Prostate Cancer mortality statistics

In 2007 there were 10,239 deaths in the UK from prostate cancer. 1-3 Prostate cancer accounts for around 13% of male deaths from cancer in the UK and is the second most common cause of cancer death in men, after lung cancer.

The number of deaths from prostate cancer and the rates for the constituent countries of the UK are shown in Table 2.1. 1-3

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The majority of prostate cancer deaths (93%) occur in men aged 65 and over as Figure 2.1 shows. In older men aged 85 and over, prostate cancer overtakes lung cancer to become the most common cause of cancer deaths. The numbers of deaths and the death rates by age are shown in Figure 2.11-3

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Prostate cancer mortality rates worldwide vary 15-fold and although North America ranks first in terms of incidence, it is eighth for mortality, with the highest rates being recorded in the Caribbean ( Figure 2.2).

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The widespread use of PSA testing in the USA results in not only higher prostate cancer incidence but also a much higher proportion of early stage cases being diagnosed than in countries with lower levels of testing and this naturally leads to higher survival rates overall and lower mortality rates relative to incidence.

For instance, 60-70% of the prostate cancers diagnosed in Japanese men have extended beyond the prostate versus only 11% in US white men. 4

Significant decreases in prostate cancer mortality have been recorded in some countries since 2002 which will not be reflected in these rankings ( Figure 2.2).

Overall in the United Kingdom, prostate cancer mortality was fairly stable during the 1970s but began to increase in the early 1980s ( Figure 2.3). Mortality peaked in the early 1990s when the European age-standardised death rate reached 30 per 100,000 in 1992. Since then there has been a slight fall in the rates and in 2007 the European age-standardised rate was 25 per 100,000. This was the first sustained decrease in annual death rates for thirty years.

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A decrease in prostate cancer mortality has also been observed in the USA since 1991 5 and in Europe since 1993. 6 A comparison of mortality rates in the USA and UK in 1975-2004, reported that mortality peaked in the early 1990s for both countries, but the subsequent fall in mortality until 2004 was much greater in the USA. 7

The UK prostate cancer mortality rates by age group between 1971-2007 are shown in Figure 2.4. Rates for men under 84 years reached a peak in 1992 and have declined consistently since then. Recent rates for men over 85 had two peaks: the first in 1996 which was followed by a decline and then a further increase to 2003, since when the rates have fallen.

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As yet it is not possible to say what proportion of the fall in prostate cancer mortality is the result of improvements in treatment, 8 changes in cancer registration coding, 9the attribution of death to prostate cancer, and the effects of PSA testing. 10 Only the ongoing randomised controlled trials can provide definitive answers about the efficacy of screening. 11