Prostate cancer cases expected to double by 2040

New research by The Lancet projects that annual prostate cancer cases will double in the next 20 years, rising from 1.4 million in 2020 to 2.9 million in 2040.

Prostate cancer deaths are expected to increase by 85% to almost 700,000 per year over the same timeframe. Low- and middle-income countries are predicted to see the highest increases in both cases and deaths.

The Lancet Commission on prostate cancer, co-authored by Movember, calls for evidence-based interventions to help save lives and prevent poor health for those with prostate cancer.

— Sarah Weller, Global Director for Prostate Cancer at Movember

More research on ethnic inequities

Research and knowledge of prostate cancer is heavily focussed on White European men, and most studies have been done in high-income countries.

However, Black men, especially those of West African descent, have a higher risk of developing prostate cancer than White or Asian men. The reasons for this are unclear. There is also a higher death rate from prostate cancer among Black men. But, again, it is not known if this is driven by the differences in case rates or by other factors such as differing disease biology or societal factors such as deprivation or racism.

The Commission authors highlight the need for more research to better understand prostate cancer in men who are not of White European origin, to enable improved detection and care in these groups.

What Movember is doing about it:

• The Movember Prostate Cancer Health Equity Initiative is providing global funding to multi-year projects that build and strengthen the evidence base of promising approaches that improve health equity.
• We’re also funding scientific research into genetic factors that underlie prostate cancer risk.
• Movember is funding many initiatives that include a focus on improving health equity for men with prostate cancer, including personalised cancer care and integration of patient-reported outcome measures, clinical quality registries and benchmark reporting, personalised active surveillance frameworks, and sexual health and wellbeing resources.

Global need to improve early detection

In many high-income countries, men aged over 50 can request a PSA test from their doctor. It’s an approach that the Commission argues leads to over-testing among low-risk older men. More targeted and personalised screening is expected to reduce both over-diagnosis and over-treatment, while detecting potentially lethal disease in those most at-risk.

In low- and middle-income areas, the effectiveness of population-level PSA testing has not been tested. The Commission is calling for cancer screening trials in these countries.

What Movember is doing about it:

• Movember is a partner within the PRAISE-U consortium, working to encourage early detection and diagnosis of prostate cancer through customised and risk-based screening programmes.
• Movember is working with research partners to build a risk-based active surveillance framework to provide a personalised approach that reduces unnecessary treatment for those with lower risk prostate cancer, and maximises detection for those who would benefit.

Better awareness of advanced prostate cancer

Treatments exist that prolong survival and decrease suffering for men with advanced prostate cancer, but awareness of these treatment options in low- and middle-income countries is limited. Similarly, public awareness of the signs of advanced prostate cancer — such as bone pain — is poor.

The Commission calls for initiatives that raise awareness of the symptoms of advanced prostate cancer and treatment options in low- and middle-income countries.

What Movember is doing about it:

• Movember’s IRONMAN registry is collecting detailed information from thousands of men with advanced prostate cancer to determine the best ways to treat the disease, enhance survival and improve their quality of life. A substudy, IRONMAN EMPRO, is using patient-reported outcome measures to test if regular remote monitoring of prostate cancer symptoms to trigger follow-up calls by clinicians will deliver better outcomes.
• Movember is a sponsor of the Advanced Prostate Cancer Consensus Conference taking place in 25 - 27 April 2024, which provides recommendations for best practice treatment standards, improving the global standard of care.
• To prevent and delay the progression of high risk prostate cancer to advanced, fatal disease, Movember has launched a global collaborative Preventing Disease Progression program to develop a biomarker-informed treatment strategy to guide treatment selection.

The Commission will be launched at the EAU Congress on Saturday 6 April 2024. Dive into the full report at thelancet.com/commissions/prostate-cancer.