National trends in incidence of prostate cancer by age, ethnicity, region, and rurality from 2000-2018: An analysis of US NPCR Database.

Abstract

e17054 Background: Prostate cancer (PC) is the most common cancer and second leading cause of cancer-related death among males in the United States. Screening recommendations and treatments for PC have changed considerably over the past two decades, with differential effects across sociodemographic groups. This study aims to characterize trends in incidence of PC from 2000 to 2018 by age, race, region, and rurality to better understand these effects on incidence. Methods: Data were obtained from the National Program of Cancer Registries (NPCR), which represents patients for all 50 states. Incidence rates and average annual percent change (AAPC) were calculated using SEER*Stat software. Incident rates were calculated as the number of new cancers arising in the prostate (ICD-O-3 Site Code: C619) per 100,000 males. Trends across sociodemographic groups were analyzed and visualized in R. Results: PC incidence decreased significantly for all ages 40 and above from 2000 to 2018. Ages 85+ experienced the sharpest decline with an AAPC of -5.5% (95% CI: -6.0% to -5.1%). However, for all 5-year age brackets between 60 and 85, incidence reaches a minimum in 2014 before rising again as shown by segmented regression analysis. All race/ethnicity groups experienced a significant decline in incidence from 2000 to 2018 with sharpest decline in Hispanics -3.9% (95% CI: -4.5% to -3.3%). All regions also experienced a significant decline, with the greatest decline in the West at -4.0 (95% CI: -4.7 to -3.3). Metropolitan counties experienced a greater decline than nonmetropolitan. Patients ages 65 to 79, of Black race/ethnicity, and metropolitan groups had the highest overall incidence over the study period in their respective categories with 2018 incidences of 663, 181, and 115 per 100,000 males respectively. Conclusions: Nearly all sociodemographic groups have experienced a decline in the incidence of PC from 2000 to 2018. However, PC incidence increased from 2014 to 2018 for several sociodemographic groups. Importantly, 65 to 79 year olds, Black Americans, and metropolitan groups had the highest incidence over the study period. This study demonstrates a sustained rise in incidence of PC for several sociodemographic groups, as well as identifies groups at higher risk of PC. These trends may be due to evolving PC screening guidelines and merit further investigation.