Prostate cancer diagnosis on the rise among U.K. men

Latest figures from Cancer Research UK reveal that the number of men diagnosed with prostate cancer in the UK has risen above 40,000.

In 2009, around 40,800 men were diagnosed with prostate cancer, rising from around 14,000 in 1989. 

Much of the increase has been linked to greater use of PSA (prostate specific antigen) testing, which measures a chemical produced by the prostate that may be raised when a man has prostate cancer.

PSA testing first started in the UK around 1989. Since then prostate cancer incidence rates have more than doubled in Britain from 47.4 to 102.9 per 100,000 men1, though the rates have been fairly stable since around the turn of the millennium.

PSA testing is not currently used as part of a national cancer screening programme. This is because high PSA levels are not a good indicator of whether or not a man has prostate cancer.

Research suggests that up to two thirds of men with high PSA levels do not have prostate cancer. The test, and later investigations, also cannot reliably distinguish between aggressive prostate cancers that need treating or slow-growing cancers that may not. This can then lead to unnecessary treatment. 

Instead of a national screening programme, men who ask for a PSA test are given information by their GP to help them understand the pros and cons before they decide whether they want to go ahead with the test.  

Professor Malcolm Mason, Cancer Research UK's prostate cancer expert, said: "Accurately diagnosing and predicting the need for treatment of prostate cancer is fraught with difficulties and there is no escaping the fact that we need a better tool than PSA to help detect prostate cancers that actually need treating. Men need to be counselled about the upsides and downsides of having a PSA test and the uncertainties that it can raise.

"We urgently need to find better tests that tell us more about a man's prostate cancer. Is the disease going to sit quietly in the background and never cause a problem or do we need to treat it aggressively? If we can accurately answer these questions, we could spare thousands of men unnecessary treatment that can lead to side effects like impotence and incontinence."

During the last ten years UK death rates from prostate cancer have fallen by 11 per cent - from 26.8 to 23.8 per 100,000 men2. This is due to a range of factors, including improvements in the treatments available for prostate cancer, such as new drugs like docetaxel and more effective radiotherapy, and possibly men having their prostate cancer being picked up earlier. Due to this fewer older men are being diagnosed with the disease and so not dying from prostate cancer.

For aggressive prostate cancers, early diagnosis remains crucial, as swift treatment offers the best chance of successful treatment.  Symptoms men should be aware of include passing urine more often than usual, especially at night, or difficulty in passing urine. These are common symptoms which usually turn out to be something much less serious for most men, but it's important they get them checked by their doctor.  

Professor Peter Johnson, Cancer Research UK's chief clinician, said: "Cancer Research UK's work has been at the heart of the progress that has improved treatments for prostate cancer. Our researchers developed the first man-made hormone to treat the disease and played a pivotal role in improving radiotherapy techniques that are more accurate and effective, saving more men's lives.

"But we also need new treatments for men with advanced prostate cancer. Cancer Research UK supported the initial development of a drug called abiraterone that is currently going through NICE approval and could be an effective drug for men who have advanced prostate cancer that has come back after chemotherapy.

"We're also funding projects to improve our understanding of the disease. As part of the International Cancer Genome Consortium - supported by the Dallaglio Foundation - we're funding a project to sequence all the genes in 250 different prostate cancers, which we hope will pinpoint the genes that are driving them.  This could help us identify men who are more likely to have the aggressive form of prostate cancer."