When it comes to prostate cancer, it is not far away and may be lurking all around us.
Prostate cancer is very common in Western countries, and according to the latest data, the incidence of prostate cancer among men in the United States has surpassed lung cancer as the number one malignancy that threatens men’s health.
Prostate cancer is the 6th most common malignant tumor in men and is more prevalent in the elderly
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In 2011, the incidence of prostate cancer ranked 6th among male malignancies in China, and was the first among urological malignancies.
It is estimated that in 2015, there were about 60,300 new cases of prostate cancer and 26,600 deaths in China. Moreover, there is a clear age difference among new prostate cancer patients, with the majority being over the age of 75 and fewer under the age of 60:
- In the 45- to 59-year-old group, there were about 3,400 new cases;
- In the 60- to 74-year-old group, about 24,200 new cases;
- For those aged 75 years or older, about 32,400 new cases.
The incidence and death of prostate cancer are significantly increasing in the higher age groups, and prostate cancer has gradually become a urological malignancy that seriously affects the health of elderly men in China.
In addition, the median age of prostate cancer incidence is 72 years, which means that half of the patients are younger than 72 years old, with a peak age of 75-79 years.
Aging population and westernized lifestyles are driving the incidence of prostate cancer
It is now believed that the increased incidence of prostate cancer in China is related to an aging population and westernized lifestyle.
Generally speaking, middle-aged and older men older than 50 years of age are at high risk for prostate cancer, and screening for prostate cancer in this population is of great interest. The current national consensus recommends annual rectal exams and PSA (prostate-specific antigen) screening for men over 50 years of age. For men with a family history of prostate cancer, the screening age should be advanced to 45 years.
In addition, obesity, one of the major manifestations of a westernized lifestyle, is an important risk factor for prostate cancer. A diet high in animal fat and lack of exercise are the main reasons for the development of obesity.
Two factors, an aging population and a westernized lifestyle, will continue to drive the incidence of prostate cancer over the next decade.
The incidence of prostate cancer in China is low compared with Europe and the United States, but the mortality rate is high, and late staging at diagnosis is the main reason
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The incidence of prostate cancer in China remains at a low to moderate level compared to other countries worldwide. However, sadly, 5% of those who die from prostate cancer worldwide live in China. The survival rate of prostate cancer in China is not promising, especially in the vast rural areas.
The survival of patients with tumors depends largely on the stage of the disease and the treatment. Despite recent advances in treatment, however, metastatic prostate cancer remains an incurable tumor.
In the United States, the overall 5-year survival rate for prostate cancer can be as high as 98%, with a 5-year survival rate of 100% for limited prostate cancer and only 30% for metastatic prostate cancer. It is important to note that 78% of cases of limited prostate cancer, 12% of cases of lymph node metastases, and only 5% of cases of distant metastases are found in the United States.
In Japan, limited prostate cancer accounts for nearly 50% of cases, whereas our study data suggest that only one third of patients with initial diagnosis have limited lesions.
Therefore, the main reason for the difference in survival rates of prostate cancer between China and Europe and the United States is due to late disease staging and thus lost opportunities for curative treatment. Early diagnosis of prostate cancer is the most effective means of improving survival, and screening for prostate cancer with PSA and rectal examinations is now the key to early detection of prostate cancer.
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