The number of men diagnosed with prostate cancer worldwide is projected to double to 2.9 million a year by 2040, with annual deaths predicted to rise by 85%, according to the largest study of its kind.
Prostate cancer is already a major cause of death and disability, and the most common form of male cancer in more than 100 countries. But with populations ageing and life expectancy rising globally, a new analysis forecasts a dramatic surge in cases and deaths over the next 15 years.
Diagnoses are projected to increase from 1.4m a year in 2020 to 2.9m by 2040, which will mean about 330 men being told they have the disease every hour.
The number of deaths worldwide is predicted to rise by 85% over the 20-year period, from 375,000 in 2020 to almost 700,000 by 2040. The true death toll will probably be higher, experts say, because of underdiagnosis and missing data in low- and middle-income countries.
The findings were published in the Lancet as part of its landmark commission on prostate cancer, and will be presented at the European Association of Urology’s annual congress in Paris on Saturday.
Ageing populations and increasing life expectancy mean the number of older men worldwide who are living for longer is rising. As the main risk factors for prostate cancer – such as being 50 or older and having a family history of the disease – are unavoidable, experts say it will be impossible to prevent the surge in cases simply via lifestyle changes or public health interventions.
However, wider awareness of the symptoms of the disease, access to testing initiatives, earlier diagnosis, and advances in treatments could still help reduce the burden and save lives, according to the authors of the 40-page report.
“As more and more men around the world live to middle and old age, there will be an inevitable rise in the number of prostate cancer cases,” said Prof Nick James, the lead author of the study. “We know this surge in cases is coming, so we need to start planning and take action now.”
“Evidence-based interventions, such as improved early detection and education programmes, will help to save lives and prevent ill health from prostate cancer in the years to come,” added James, a professor of prostate cancer research at the Institute of Cancer Research, London, and a consultant clinical oncologist at the Royal Marsden NHS foundation trust.
James said there was a global need for new and improved ways to test for the disease, to reduce overdiagnosis and overtreatment while detecting potentially lethal tumours earlier.
Boosting knowledge among men and their families of signs to look for was also key, according to the report.
Symptoms of prostate cancer can include needing to urinate more frequently, often during the night; needing to rush to the toilet; difficulty in starting to pee; feeling that your bladder has not emptied fully, and blood in your urine or semen.
These symptoms do not always mean you have prostate cancer. Many men’s prostates become larger as they get older because of a condition called benign prostate enlargement. Signs that prostate cancer may have spread include testicle, back or bone pain, a loss of appetite, and unintentional weight loss.
The study also highlighted the need for more research to better understand prostate cancer in black men, as most research has focused on white men.
Alfred Samuels was 54 when he learned he had advanced prostate cancer in 2012. He had worked in the entertainment industry for three decades, providing security for celebrities including Beyoncé and Bob Dylan – but the shock diagnosis ended his career overnight. Doctors ruled out surgery when tests showed his cancer had spread, and the father of six started to lose hope.
However, he then joined a clinical trial and began treatment with a drug that is now extending the lives of thousands of men worldwide. Twelve years later, Samuels, from Harrow in north-west London, has welcomed six grandchildren to the world and pivoted to a second career raising awareness of cancer research.
“Due to the late stage that my prostate cancer was diagnosed, I wouldn’t be here today if I hadn’t been able to access a clinical trial. It was my lifeline,” said Samuels, now 66. “This report has been a long time coming. Now it needs to be mandatory to record ethnicity in clinical trials, and trials must reflect the ethnic diversity of the population, so that we can find better treatments for people like me.”
Amy Rylance, the head of improving care at the charity Prostate Cancer UK, said the Lancet report was a “a timely call to action”. She added that healthcare systems must do better at recognising those at highest risk: black men and men with a family history of prostate cancer or genetic risk factors such as BRCA variations.
