A new Lancet Commission report shows that prostate cancer is expected to increase dramatically over the next two decades and cause the same number of deaths as breast cancer by 2030. Total new cases of prostate cancer per year for the entire globe will increase to almost two times the number in 2020, which was 1. 4 million, reaching around 2. 9 million by the year 2040. Similarly, the deaths are expected to rise to almost 700 000 per annum from the current 375 000 by 2030 an 85% rise.
Prostate Cancer Rates to Rise By 115% By 2040
Most of this increase occurs in LMICs, as aging populations and longer life spans contribute to the incidence. Related to this, increased life expectancy and a growing number of men over 50 years old in developing nations will contribute to the growth of the instances of the disease. Death rates are also rising in LMICs while the global trend reveals that they have decreased significantly in most HICs since the early 1990s.
Furthermore, if no measures are taken, most of the estimated 700,000 annual prostate cancer fatalities in 2040 will be in LMICs. This explains why patients in these countries are often diagnosed in the advanced stages leaving them with shorter life expectancies. Apart from the lives lost, the report stated that this estimated increase in cases and deaths could lead to serious economic and social impacts on families in LMICs whose main breadwinners is a man.
Screening is an early detection key, but the debate continues.
The report states that it is necessary to develop early detection programs to mitigate the consequences of the future increase in the incidence of prostate cancer, firstly, in the countries of the third world. Nonetheless, a controversy in the current literature exists about even high-income countries concerning the most effective approach to screening.
The most widely used screening method is the PSA blood test for men over 50 years of age or older. However, the Commission argues that PSA testing, with informed choice, results in over-diagnosis of low-grade prostate cancer in elderly men and under-diagnosis of higher-risk pre-dominantly young black men. This is the reason why the document recommends the use of MRI scans in combination with PSA tests to screen only high-risk populations.
We are yet to ascertain the effectiveness of PSA testing at a population level in the LMICs. The Commission emphasized the need to assess the efficacy of both PCa screening strategies in developing countries under the framework of other men’s health interventions. It also suggested the employability of mobile testing as well as outreach campaigns as measures to enhance the uptake of screening by those most vulnerable.
Increasing Disease Awareness and Enhancing Treatment Opportunities in Developing Nations
Among the recommendations in the Lancet report, the issue of improving patients’ awareness of metastatic prostate cancer in LMICs was also mentioned along with the need for its earlier diagnosis. It stated that many people hardly know the signs of an aggravated disease or if there are chances that the condition can be treated to prolong life.
Among the current metastatic prostate cancer treatments, hormonal therapy is pointed out as the accessible treatment option, which is available in many developing countries. However, the clinical capacity as it stands cannot cope with the growing demand. The Commission has suggested that there should be regional treatment centers to enhance expert practice and make some vital radiotherapy and operations accessible to patients.
It also envisions new awareness campaigns that incorporate the use of smartphones, social media, and influential personalities. The study also provided examples of organizations that managed to engage public figures and technology to spread cancer awareness – Project PINK BLUE from Nigeria.
Self-education about Inequalities – Cancer Research Is Biased in Favor of White Citizens All Around the World
Despite acknowledging that prostate cancer remains a huge threat for developing nations in the future, the Lancet Commission identifies it as a signal of a more profound shift that is required in the health systems to be ready for growing elderly populations. It also pointed out the lack of knowledge about many aspects of prostate cancers and their treatment, particularly concerning those populations that are not White.
According to the report, most of the cancer studies done internationally are in Whites, and therefore, very little is known about cancer in other ethnic groups. Specifically, it asserts that ethnic origins are to be recorded in trials and the inclusion of ethnic minorities in research samples.
This is rather significant, particularly because Black men in the United States with West African heritage have a higher propensity to be diagnosed with prostate cancer and experience mortality than White and Asian populations. However, the causes of these trends are rather ambiguous or not quite transparent.
Therefore, according to the Lancet Commission, it is expected that the increase in the incidence of prostate cancer will soon affect LMICs over the next twenty years. Its sources suggest that increasing cases and deaths of lung cancer can be addressed by early detection campaigns, treatment access initiatives, and research studies concerning the non-White population. The report and its findings finally view the increasing incidence of prostate cancer as an indicator of the future burden that aging populations will bring in the context of increasingly strained health systems, especially in the developing world.
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