Department of Radiation Oncology, and Division of Urology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ONT, Canada.
Study Type - Health forecast analysis (based on trend prediction with sensitivity analysis) Level of Evidence 2a.
To estimate the magnitude of increase in prostate cancer cases diagnosed in Canada by the year 2021.
Using available evidence, the number of new prostate cancer cases expected in 2021 was estimated based on the effects of four major factors: aging population, increased prevalence of PSA screening, lowered PSA cutoff to recommend biopsy, and improved sensitivity of prostate biopsy. These effects were combined with population data from Statistics Canada and the Canadian Cancer Statistics to estimate new prostate cancer cases.
The two factors with the largest effect on estimated new prostate cancers in 2021 compared with 2009 were: aging population (increase of 39%), and lowering the PSA threshold to 2.6 ng/mL before prostate biopsy (increase of 200%). In the 'best-case' scenario, the number of new prostate cancers will only be affected by the aging population and will increase by 39% to 35 121 new cases. In the 'most-likely' scenario, all four factors will have a combined effect to increase new cases by 201% to 76 379.
The aging population and lowering PSA threshold to 2.6 ng/mL have the most significant impact on estimated new prostate cancer cases in 2021. At that time, the number of new cases may triple to 76 379 cases in Canada. Significant planning will be required to manage this considerable increase in new prostate cancers. What's known on the subject? and What does the study add? Estimates of prostate cancer cases are often based solely on changes in the age distribution of the population or on historical trends. This study also incorporates changes in screening prevalence, sensitivity screening maneuvers and lowering threshold for biopsies.
Quon H, Loblaw A, Nam R. Are you the author?
Reference: BJU Int. 2011 Apr 20. Epub ahead of print.