Prostate cancer: key points

• In Scotland, prostate cancer is the third most commonly diagnosed cancer in men, after non-melanoma skin cancer and lung cancer.  It is the third most common cause of death from cancer in men, after lung and colorectal cancer.
• Currently, around 2,670 men are diagnosed with prostate cancer in Scotland every year.
• Excluding non-melanoma skin cancer, prostate cancer accounts for 19% of all cancers diagnosed in men.
• Based on current rates of disease, an estimated 1 in 12 men develop prostate cancer during their lifetime.
• Between 1999 and 2009, the age-standardised incidence rate of prostate cancer increased by an estimated 17%.
• While part of the increasing incidence of prostate cancer may reflect a genuine increase in risk, much of it seems likely to reflect increased detection of latent disease through increasing use of the prostate-specific antigen (PSA) test.
• Variations in use of PSA testing make it difficult to interpret geographical variations in incidence and survival.
• The causes of prostate cancer are largely unestablished, but the main risk factors seem to be increasing age, family history, African descent, and various aspects of diet. 
• As a potential screening test, PSA has limitations and, at present, there is no evidence that screening with PSA decreases the risk of dying from prostate cancer.  However, two large randomized trials of screening for prostate cancer are currently underway in Europe and the USA. 
• Survival from prostate cancer is moderately favourable with a 5-year relative survival of 85.5% in patients diagnosed between 2003 and 2007.
• The incidence of prostate cancer is higher among men from areas of less socioeconomic deprivation, but it is not clear whether this is due to genuine differences in risk or simply differences in detection through use of the PSA test.  The probability of surviving prostate cancer is lower among people living in areas of socioeconomic deprivation - again, this might be explained by a lower proportion of PSA-detected latent disease among this patient group.
• A previous population-based audit of prostate cancer in Scotland identified inconsistencies in disease management and highlighted the need for a multidisciplinary approach, which has now become standard practice.

Key Statistics:

Notes:
(1) Number of prostate cancer survivors at 31 Dec 2007 who had been diagnosed in the previous 20 years per 100,000 male population.
(2) Five year relative survival for patients diagnosed during the period 2003 -2007 (not standardised).