Login to Access Video or Poster Abstract: MP14-15
Sources of Funding: None

Introduction

Recent population-based studies have suggested that the incidence of metastatic prostate cancer in the United States has remained unchanged over the past decade. These studies have pooled lymph node metastatic cancers with localized disease, and have used a methodology that may be suboptimal for examining aggregate trends in the incidence of distant metastases. Determining if diminished screening has coincided with an increase in the incidence of metastatic prostate cancer is important, as it suggests a reversal of the trend towards decreasing metastases that followed the advent of prostate specific antigen screening. We sought to examine temporal trends in the incidence of prostate cancer with distant and/or pelvic lymph node metastasis [PLNM] at diagnosis.

Methods

Using the most recent release of Surveillance Epidemiology, and End Results (SEER), we examined the standardized quarterly incidence of prostate cancers with distant or nodal metastases in men over 50 years of age from 2004 to 2013 using a piecewise regression model. Incidence was stratified by age (≥75 and <75 years).

Results

The incidence of prostate cancer with nodal or distant metastases decreased in men ≥75 years from the first quarter of 2004 to the second quarter of 2011 (p<0.01), and increased significantly afterward (p<0.01). There was no change in the incidence of advanced disease in men less than 75. _x000D_ _x000D_ Separated into components, we found that the incidence of distant metastases in men ≥75 years, which had been downtrending from 2004 to 2011 (p<0.01), subsequently began increasing in the second quarter of 2011 (p=0.03). There was no change in the incidence of distant metastasis in men <75 years. PLNM in the absence of distant metastasis increased in men aged 50-74 years as well as those aged ≥75 years (p<0.01, respectively). _x000D_

Conclusions

In older men, the incidence of advanced prostate cancer at diagnosis, which had been decreasing from 2004 to 2011, increased from the second quarter of 2011 to 2013. This was driven both by a shift in the incidence of distant metastasis, as well as a persistent rise in PLNM over the past decade.

Funding

None