Prostate cancer cases expected to double worldwide between 2020 and 2040, new analysis suggests

05 Apr 2024

Cases of prostate cancer are projected to double from 1.4 million per year in 2020 to 2.9 million per year by 2040, with low- and middle-income countries (LMICs) predicted to see the highest increases in cases, according to The Lancet Commission on prostate cancer which will be launched by a presentation at the European Association of Urology Congress. 

The Commission was produced by 40 experts from around the globe, including several researchers from the MRC Clinical Trials Unit at UCL. It was led by Professor Nick James, Chief Investigator of the Unit's STAMPEDE2 clinical trial in advanced prostate cancer.

The number of annual prostate cancer deaths worldwide is predicted to rise by 85% over the 20-year period, from 375,000 deaths in 2020 to almost 700,000 deaths by 2040. The true numbers will likely be much higher than the recorded figures due to under-diagnosis and missed opportunities for data collection in LMICs.

Most of these deaths are expected to be in LMICs, due to the rising number of cases and increasing mortality rates in these countries. Deaths from prostate cancer have declined in most high-income countries (HICs) since the mid-1990s. 

Prostate cancer is already a major cause of death and disability, accounting for 15% of all male cancers. It is the second most common cause of cancer deaths in UK men and the most common form of male cancer in more than half of the world’s countries. 

Ageing populations and increasing life expectancy will lead to higher numbers of older men in coming years. As the main risk factors for prostate cancer – such as being aged 50 or older and having a family history of the disease – are unavoidable, it will not be possible to prevent the upcoming surge in cases through lifestyle changes or public health interventions.

The Lancet Commission on prostate cancer argues that the ‘informed choice’ programme for prostate cancer screening with PSA testing, which is common in HICs, may lead to over-testing and unnecessary treatment in older men, and under-testing in high-risk younger men. The authors advocate instead for early-detection programmes for those at high risk.

The Commission also calls for urgent implementation of programmes to raise awareness of prostate cancer and for improvements in early diagnosis and treatment in LMICs – where most men present with late-stage disease.

Additionally, more research involving men of different ethnicities, especially those of West African descent, is needed, as current knowledge of prostate cancer is largely based on studies of white men.

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