Abstract: PD03-09
Sources of Funding: This work was supported by the NCI Comprehensive Cancer Center Support Grant, (P30CA93373)

Introduction

Early detection of prostate cancer with PSA based screening can reduce the risk of prostate cancer mortality by 21%. Screening for prostate cancer has dramatically declined in the United States since the United States Preventive Services Task Force (USPSTF) recommended against routine PSA based prostate cancer screening for all men in 2012. This led to dramatic reductions in the diagnosis of localized disease across all clinical risk groups. We sought to study trends in newly diagnosed metastatic prostate cancer incidence, specifically the impact of patient age and race.

Methods

We analyzed new prostate cancer incidence by stage at diagnosis between 1988-2014 using data from the California Cancer Registry. We further stratified cases by age and four major race/ethnicity groups (non-Hispanic white (NHW), non-Hispanic black (NHB), Hispanic and non-Hispanic Asian/PI (API)). Incidence rates per 100,000 were age-adjusted to the 2000 US Standard Population. Joinpoint regression was used to detect changes in incidence and to calculate the average percent change (APC) over time. Joinpoint finds the best fit model with the smallest number of joinpoints and will not add an additional joinpoint if it does not make significant improvement on the model.

Results

Adjusted rates of remote prostate cancer incidence for men of all races aged 65-74 and NHW men of all ages significantly increased over the most recent time period by 2.4% and 1%, respectively, p<0.05 (Figure 1 and 2). In contrast, incidence of remote prostate cancer continued to decline for NHB (-2.42%), Hispanic (-1.94%), and API (-1.66%) men. Localized disease incidence continues to decline significantly for all age and racial groups.

Conclusions

Incidence rates of newly metastatic prostate cancer have significantly increased for the first time in California for men aged 65-74 and white men. Although not possible to determine the etiology of these findings, decreased PSA screening and early detection of aggressive as well as indolent tumors is likely to contribute. _x000D_

Funding

This work was supported by the NCI Comprehensive Cancer Center Support Grant, (P30CA93373)