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The Lancet Commission on Prostate Cancer has issued a stark warning this week, predicting an “inevitable” surge in prostate cancer cases globally. According to the commission, cases are projected to double to 2.9 million, with an 85% increase in deaths to nearly 700,000 by the year 2040.
At a gathering of urologists in Paris, France, lead author of the Lancet report, Dr. Nick James, emphasized that the acceleration of this surge is already evident in high-income countries such as the United States and the United Kingdom. However, the momentum is expected to intensify in low- and medium-income countries as well.
Dr. James explained, “Prostate cancer paradoxically is a problem baked into the biology. Men get prostate cancer as they age.” With a significant rise in the number of individuals in their 50s, 60s, and 70s anticipated in the coming decades, particularly in poorer countries, the incidence of prostate cancer is set to increase.
The Lancet report, set to be presented at the 2024 European Association of Urology Congress in Paris on April 6, advocates for proactive measures, including enhanced screening efforts using technologies such as MRI, particularly for men aged 50–70 years in high-income countries and those of African origin aged 45–70 years.
Dr. Andrew Vickers, a biostatistician at Memorial Sloan Kettering Cancer Center in New York City, echoed the Lancet Commission’s sentiments, emphasizing the need for improved screening strategies. He highlighted the misuse of prostate-specific antigen (PSA) screening, which has led to overuse, overdiagnosis, and overtreatment.
Dr. James also addressed the issue of undertreatment of advanced disease, noting that only about 30-40% of men in the United States receive combination hormone therapy for metastatic disease.
A particular concern highlighted in the report is the disproportionately higher risk of prostate cancer among men of African ancestry. Dr. Brandon Mahal, vice chair of research in radiation oncology at the University of Miami Sylvester Comprehensive Cancer Center, emphasized the importance of including more men of African ancestry in research to address this disparity.
Innovative approaches to enable earlier diagnosis, especially in low- to middle-income countries where most patients present with metastatic disease, were also discussed. Dr. James advocated for initiatives such as pop-up clinics and mobile testing to reach high-risk individuals who may not otherwise seek medical attention.
Drawing from his experience with outreach programs like The Man Van in England, Dr. James emphasized the importance of community-based interventions in detecting prostate cancer early and saving lives.
Despite the looming crisis, Dr. James remains cautiously optimistic, suggesting that increased utilization of nurses and artificial intelligence could help alleviate the strain on healthcare systems worldwide.
However, he cautioned that the medical community must act swiftly to prepare for the impending surge in prostate cancer cases, as the solution cannot solely rely on training more specialized professionals.
As the global healthcare landscape braces for the challenges ahead, the Lancet Commission’s warning serves as a clarion call for concerted action to address the looming prostate cancer crisis.
Howard Wolinsky is a medical writer based in Chicago.
