Recent trends in prostate cancer in Canada

Area of Science:

• Oncology
• Public Health
• Epidemiology

Background:

• Prostate cancer is the most common cancer in Canadian men.
• Screening guidelines for prostate cancer have evolved, with taskforces recommending against prostate-specific antigen (PSA) testing in low-risk men since 2011/2014.
• This study analyzes trends in prostate cancer incidence, mortality, and stage at diagnosis in Canada.

Purpose of the Study:

• To report on trends in prostate cancer incidence, mortality, and stage at diagnosis in Canada between 1992 and 2015.
• To correlate observed trends with changes in prostate-specific antigen (PSA) screening recommendations.
• To provide data for future public health strategies and monitoring.

Main Methods:

• Utilized data from Statistics Canada's Canadian Cancer Registry and Canadian Vital Statistics - Death Database.
• Employed Joinpoint analysis to identify and quantify trends in age-standardized incidence and mortality rates.
• Examined changes in the rates of localized (Stage I/II) versus advanced (Stage III/IV) prostate cancer.

Main Results:

• Prostate cancer incidence rates peaked in 1993 and 2001, declining annually by 9.3% from 2011-2015.
• Mortality rates decreased continuously from 1992-2015, with accelerated decline post-2001 (2.9% per year).
• Localized cancer rates decreased by 3.2% annually (2005-2015), while advanced cancer rates remained stable.

Conclusions:

• Prostate cancer incidence has significantly decreased in recent years, primarily in localized stages.
• Observed incidence trends align with shifts in prostate-specific antigen (PSA) screening recommendations.
• Ongoing national surveillance of prostate cancer trends is crucial, particularly in relation to screening practices.