Abstract: PD03-12
Sources of Funding: None

Introduction

In 2008 and extended in 2012, the US Preventive Services Task Force (USPSTF) issued guidelines stating there was insufficient evidence to support prostate cancer screening. Using the Surveillance Epidemiology and End Result (SEER) database, we sought to determine the effect of recent USPSTF recommendations on prostate cancer incidence based on Gleason score (GS), and to identify differences in GS based on race.

Methods

SEER database was analyzed from 2008-2013. Patients were divided based on recorded race. GS were stratified as low (2-6), intermediate (7) or high (8-10). Incidence was compared between 2008 and 2013 by determining incidence rate ratio (IRR) and annual percentage change (APC). Statistical analysis was performed with SEERSTAT and excel, confidence interval was set at 95%, with p< 0.05 as significant.

Results

337,504 patients diagnosed with prostate cancer within SEER 18 between 2008 and 2013 were included in the analysis. The mean age range was between 65-74 years. Majority (68.1%) of patients were White, followed by 14.6% Black. GS 2-6 was recorded for 41.8%, followed by GS 7 in 36.2% of patients, and GS 8-10 in 15.9% of patients. Cumulative six year GS 2-6 incidence was noted to be 76.2, 52.9, 44.7 and 25.0 per 100,000 for Black (B), White (W), Hispanic (H), and Asian/Pacific Islanders (API), respectively. GS 7 incidences were 81.3, 46.4, 36.2 and 23.4 per 100,000 for B, W, H, and API, respectively. GS 8-10 was reported in 37.5, 21.0, 21.7 and 18.0 per 100,000 for B, W, H, and API, respectively. The IRR demonstrated a decline in incidence across races and Gleason scores. Between 2008 and 2013 GS 7 IRRs were 0.74 B, 0.65 W, 0.61 H, 0.60 API and GS 8-10 IRRs were 0.85 B, 0.89 W, 0.83 H, 0.78 API. APC significantly declined among all races for GS 2-6 (-8.56 B, -8.87 W, -8.63 H and -8.68 API) and GS 7 (-6.54 B, -8.56 W, -9.23 H and -9.91 API). Additionally, APC significantly declined for B and H GS 8-10 (-3.51 B, -4.39 H). APC of GS 8-10 incidence showed no statistically significant increase or decline for W and API (-2.28 W, -5.05 API).

Conclusions

Analysis of SEER demonstrates a decline in incidence of prostate cancer among all races. Notably, there was a decline in GS 8-10 prostate cancer incidence for B, W, H, and API groups, suggesting reduced diagnosis of aggressive prostate cancer in the USPSTF guideline era.

Funding

None