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New findings led by researchers at the American Cancer Society (ACS) show the highest mortality rates for prostate cancer in White men were found in the Western region of the United States, including California, despite low incidence rates. Black men, however, had an estimated 70% to 110% higher incidence and mortality rate for prostate cancer than White men overall in the U.S. The study also showed persistent sociodemographic disparities and unfavorable trends in incidence or mortality for all four major genitourinary cancers (bladder, kidney, prostate, and testicular) for men and women in the U.S. The study was published today in the journal European Urology.

“These data are a call to arms. Approximately 444,660 newly diagnosed genitourinary cancer cases and 67,330 deaths are expected to occur in 2022 in this country, accounting for 23% of all cancer cases and 11% of all cancer deaths. Prostate cancer can be readily treated and eradicated when detected in early stage, yet this cancer type persists as the second leading cause of cancer death amongst men in the United States. Moreover, overall trends show a deeply concerning shift toward diagnosis of later stage disease. We can and must do more,” said Dr. Karen E. Knudsen, chief executive officer at the American Cancer Society and senior author of the study. “This study reveals striking geographic and racial disparities that should be studied and mitigated. Our data identify a significant burden on a subset of populations, including men in the West and Black men overall. ACS is committed to being part of the change, toward advancing prevention programs, early detection of disease, and better medical treatment and care for prostate cancer.” 

For this study, researchers analyzed incidence rates for bladder, kidney, prostate, and testicular cancers in the U.S. from the Surveillance, Epidemiology, and End Results (SEER) Database at the National Cancer Institute (NCI), mortality rates from the U.S. Cancer Statistics database from the Center for Disease Control and Prevention, and the National Center for Health Statistics (NCHS). They examined cross-sectional and temporal trends in incidence and death rates stratified by sex, race/ethnicity, and county. Age-adjusted incidence and death rates were calculated by the NCI’s SEER Stat software and temporal trends were analyzed using the Joinpoint Regression ProgramFor this study, researchers analyzed incidence rates for bladder, kidney, prostate, and testicular cancers in the U.S. from the Surveillance, Epidemiology, and End Results (SEER) Database at the National Cancer Institute (NCI), mortality rates from the U.S. Cancer Statistics database from the Center for Disease Control and Prevention, and the National Center for Health Statistics (NCHS). They examined cross-sectional and temporal trends in incidence and death rates stratified by sex, race/ethnicity, and county. Age-adjusted incidence and death rates were calculated by the NCI’s SEER Stat software and temporal trends were analyzed using the Joinpoint Regression Program.

Study results showed incidence rates increased for kidney and testicular cancers and for advanced-stage prostate cancer in almost all racial/ethnic populations. Researchers also reported incidence and death rates for bladder and kidney cancers continued to be two to four times higher in men than in women.

Other key findings from the study:

• Geographically, the highest incidence rates among White individuals were found in the Northeast for bladder cancer and in Appalachia region and parts of the south for kidney cancer.
• Incidence rates increased for bladder cancer in American Indian and Alaska Native individuals.
•  For testicular cancer, incidence rates increased in all racial and ethnic groups, while mortality rates increased only in Hispanic men.
• Mortality rates stabilized for prostate cancer among White and Asian American/Pacific Islander men, after a steady decline since the early 1990s.
   

"Previous studies have reported that differences in prevalence of cigarette smoking, obesity, and consumption of unhealthy diet, as well as inequity in receipt of standard of care, may have contributed to the disparities in incidence and mortality rates for some of the genitourinary cancers,” said Elizabeth Schafer, associate scientist II, surveillance and health equity science at the American Cancer Society and lead author of the study. “However, further study is needed to better understand the causes of these disparities and help save lives.”

“The continued increase in both the incidence, and the percentage of men presenting with regional and advanced disease prostate cancer is quite concerning,” said Dr. William Dahut,  chief scientific officer at the American Cancer Society and contributing author of the study. “Some of this can be explained by changes in screening patterns but the persistence of this finding suggests the possibility of a biologic or environmental factor.”

Other ACS authors participating in this study include: Dr. Daniel Wiese, Dr. Hyuna Sung, Tyler Kratzer, Dr. Farhad Islami, and Dr. Ahmedin Jemal.