Evidence of increased prostate cancer detection in men aged 50 to 59: A review of 324,684 biopsies performed between 1995 and 2002

Objectives. To analyze the age-specific detection rate of prostate cancer diagnosed from 324,684 biopsies submitted to a single laboratory and to assess the degree of prostate cancer in younger men. The advent of prostate-specific antigen (PSA) testing and increased prostate cancer screening has led to increased evaluations for prostate cancer. The initial stage and age at presentation in prostate cancer has shifted. Methods. From 1995 through 2001, all prostate biopsies submitted to the laboratory were reviewed and analyzed for the diagnosis of prostate cancer, cancer detection rate, and age at diagnosis. Results. The overall detection rate of prostate cancer increased by 15% from 29% to 34% for all biopsies submitted during the study period. For the age group 50 to 59 years, a 45% increase occurred in the detection of prostate cancer from a baseline of approximately 11% in 1995 to greater than 16% in 2001. For the age group 70 to 79 years, the detection of prostate cancer decreased from a baseline of 41% in 1995 to 36% in 2001. Conclusions. The increase in prostate cancer diagnosis among younger men in the United States has been significant. The increase is likely multifactorial and may be attributable to the impact of PSA and prostate cancer screening efforts. This has led to a greater number of younger men undergoing evaluation for prostate cancer. Thus, a heightened awareness regarding the diagnosis of prostate cancer among younger men is needed.