Abstract

View the most recent version.

Background

Prostate cancer is the most common type of cancer in Canadian men. Screening recommendations have changed substantially over the last 25 years. Since 2011 (United States) and 2014 (Canada), taskforce guidelines have recommended against screening using the prostate-specific antigen (PSA) test in low-risk men of all ages. This work reports on trends in prostate cancer incidence, mortality, and stage at diagnosis in Canada from 1992 to 2015.

Data and methods

Prostate cancer incidence, mortality, and stage at diagnosis were retrieved from Statistics Canada’s Canadian Cancer Registry and Canadian Vital Statistics - Death Database. Joinpoint analysis was used to examine trends over time.

Results

The age-standardized incidence rate (ASIR) of prostate cancer peaked in 1993 and 2001, and declined thereafter. From 2011 to 2015, the ASIR declined by 9.3% per year. The age-standardized mortality rate (ASMR) decreased continuously from 1992 to 2015, but fell most rapidly (2.9% per year) after 2001. Data from two provinces show that, from 2005 to 2015, the rate of Stage I and Stage II cancers decreased by 3.2% per year, while the rate of Stage III and Stage IV cancers remained relatively stable.

Interpretation

Incidence of prostate cancer has declined substantially in recent years. Most of the decline seems to be in localized cases (Stage I and Stage II). Changes in incidence have mirrored changes to PSA screening recommendations. Future work should continue to monitor trends over time at the national level, especially as they relate to screening recommendations.

Keywords

Cancer, prostate, prostate-specific antigen, screening, men’s health, public health

DOI: https://www.doi.org/10.25318/82-003-x201900400002-eng

Findings

Part of a man’s reproductive and urinary systems, the prostate is a small gland just below the bladder. Changes in the cells of the prostate can lead to benign conditions such as prostatitis or benign prostate hyperplasia, pre-cancerous conditions such as prostatic intraepithelial neoplasia, or prostate cancer. Prostate cancer is the most common type of cancer in Canadian men, followed by colorectal, lung, and bladder cancers. Recent analyses from the Canadian Cancer Society suggest that 1 in 7 men will be diagnosed with prostate cancer in their lifetime and that 1 in 29 will die from the disease. [Full Text]

Authors

Allana G. LeBlanc (allana.leblanc@canada.ca), Alain Demers, and Amanda Shaw are with the Adult Chronic Diseases and Conditions Division, Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ontario.