Prostate cancer tends not only to be more aggressive and progressive in black men, leading to advanced disease, but also of a higher grade at diagnosis in this population.
Approximately 10%-20% of newly diagnosed prostate cancer cases involve locally advanced disease; nonetheless, advanced disease is comparably less common because more early-stage cancer is being discovered. Accumulating evidence links early diagnosis and treatment with the decline in the prostate cancer mortality rate since the 1970s.
Despite the apparent survival advantage of early diagnosis conferred by PSA screening, the US Preventive Services Task Force recommends against screening for prostate cancer, citing overdiagnosis from detection of clinically insignificant cancers. The American Cancer Society recommends that, starting at age 50 years in those at average risk, asymptomatic men with at least a 10-year life expectancy be given an opportunity to decide whether they wish to undergo screening after receiving information on the uncertainties, risks, and benefits of screening from their healthcare provider.
A review of almost 800,000 cases of prostate cancer diagnosed from 2004 to 2013 found that although the incidence of low-risk prostate cancer decreased from 2007 to 2013 to 37% less than that of 2004, the annual incidence of metastatic prostate cancer during those years increased to 72% more than that of 2004. The increase in metastatic prostate cancer was greatest (92%) in men aged 55-69 years. Most cases are diagnosed in individuals aged 55-74 years; the median age at diagnosis is 66 years.
For more on the epidemiology of advanced prostate cancer, read here.
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Cite this: Bradley Schwartz. Fast Five Quiz: Test Your Knowledge of Advanced Prostate Cancer - Medscape - Nov 16, 2017.