Announcing the Lancet Commission on Prostate Cancer

Abstract

Prostate cancer is the second most frequent cancer in men, and there were about 1·4 million new cases around the world in 2020. 1 Sung H Ferlay J Siegel RL et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021; (published online Feb 4.)https://doi.org/10.3322/caac.21660 Crossref PubMed Scopus (2010) Google Scholar , 2 Ferlay J Ervik M Lam F et al. Global Cancer Observatory: cancer today. https://gco.iarc.fr/todayDate: 2020 Date accessed: April 16, 2021 Google Scholar Prostate cancer accounts for an estimated 15% of all cancer cases in men worldwide and is the most common form of cancer in men in in 112 countries (figure). Globally, there are many hundreds of thousands of premature deaths from prostate cancer annually, 3 Bray F Ferlay J Soerjomataram I Siegel RL Torre LA Jemal A Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018; 68: 394-424 Crossref PubMed Scopus (33702) Google Scholar and a huge toll in morbidity, particularly bone metastases leading to pain, fracture, and disability. 4 James N Pirrie S Pope A et al. TRAPEZE: a randomised controlled trial of the clinical effectiveness and cost-effectiveness of chemotherapy with zoledronic acid, strontium-89, or both, in men with bony metastatic castration-refractory prostate cancer. Health Technol Assess. 2016; 20: 1-288 Crossref PubMed Scopus (19) Google Scholar Curative treatment itself can also cause adverse effects on urinary and sexual function. 5 Hamdy FC Donovan JL Lane JA et al. 10-year outcomes after monitoring, surgery, or radiotherapy for localized prostate cancer. N Engl J Med. 2016; 375: 1415-1424 Crossref PubMed Scopus (1360) Google Scholar There is a growing tension between the need to diagnose advanced disease early while not overdiagnosing lower risk disease that probably does not need treatment.