Prostate cancer incidence will increase in future

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Prostate cancer is already most frequently diagnosed cancer among men in the developed world. As a cause of death among males, it is second in the USA and third in Europe. Large increase in prostate cancer incidence in recent years is not only due to availability of PSA (biochemical marker, which is useful for screening purposes) and due to better awareness of doctors and population at large, but in large part also due to changes in population pyramid and increased life expectancy. As breast cancer, which is most common in females over 60 years of age, also prostate cancer is cancer of older people. For example, in Slovenia (which may be in health related issues regarded somewhere in-between developed western and less advanced other parts of the world), incidence of prostate cancer increased 50% from 2000 to 2011 [14]. At the same time, population at main risk (males above age 60) increased 28%. Therefore more than half of increase of prostate cancer incidence can not be attributed to, as some people, even health care professionals, claim, "artificial" increase of incidence due to "over-screening", but simply to the fact that population at risk has significantly increased. And among those (males between 55 and 70), screening is most appropriate because life expectancy also increases (at present, for 75 year old man in Slovenia it is on average more than 10 years) and therefore cancer control is worthwhile.

In our country, recently prostate cancer incidence has been higher compared to breast cancer. Cause for this is not better prostate cancer "screening", but simple fact of changes in population pyramid, in numbers of populations at risk: relation between males and females in most important age range for prostate and breast cancer detection has changed - number of males grows significantly faster than number of females. In year 2000, 700 more females reached age of 60 compared to males, in 2011, 500 more males reached age 60 compared to females [15]. Although among oldest old, number of females will remain higher compared to men, present big gap in number of men compared to women in age group 50-70 is getting smaller and smaller and this also contributes to further increase of significance of prostate compared to breast cancer.

According to population pyramid, further increase of burden due to prostate cancer is expected, for example in our country, until year 2050, when overall population in Slovenia will, according to present trends, decrease from current 2 to 1.9 million, but number of males, age 60 or more, will peak at 1.8 times the number in 2011. Similar trend is expected to happen in most countries in the world sooner or later and therefore prostate cancer will remain important health problem in future.

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