Prostate cancer.
OBJECTIVE
We quantified the burden of prostate cancer in the United States by identifying trends in incidence, disease presentation, survival rates and use of health care resources, and by estimating the economic impact of the disease.


METHODS
The analytic methods used to generate these results were described previously.


RESULTS
Age adjusted prostate cancer incidence rates peaked in 1992 at 237/100,000 men, decreased in 1995 and then increased at approximately 1.7% yearly through 2000, when the rate was 180/100,000. Marked stage migration and an improvement in 5-year overall survival were also noted. Age adjusted inpatient hospitalizations for prostate cancer decreased in the 1990s from 729/100,000 population in 1992 to 309/100,000 in 2001. Considerable ethnic and regional variation was noted. During the same period age adjusted radical prostatectomy rates varied from 128/100,000 men in 1994 to 108/100,000 in 2000. Surgery rates decreased in older men, while they increased in younger men. Outpatient physician office visits also varied in the 1990s with ethnic and regional variation again noted. Finally, the total medical expenditure for prostate cancer treatment was $1.3 billion in 2000, which represents a 30% increase over the total expenditure for 1994.


CONCLUSIONS
The burden of prostate cancer in the United States is considerable and it appears to have markedly increased in the prostate specific antigen era. Further research is needed to determine if we are using our limited health care resources appropriately for the diagnosis and treatment of this common malignancy.
Penson
David F
DF
Departments of Urology and Preventive Medicine, Keck School of Medicine, University of Southern California, 1441 Eastlake Avenue, Los Angeles, CA 90089, USA. penson@usc.edu
Chan
June M
JM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000706:statistics & numerical data / Q000639:trends; D017281:Cost of Illness; D005102:Health Expenditures / Q000706:statistics & numerical data* / Q000639:trends; D006295:Health Resources / Q000706:statistics & numerical data / Q000639:trends; D006760:Hospitalization / Q000706:statistics & numerical data / Q000639:trends; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy / Q000706:statistics & numerical data / Q000639:trends; D011471:Prostatic Neoplasms / Q000191:economics* / Q000453:epidemiology* / Q000628:therapy; D015996:Survival Rate; D014481:United States / Q000453:epidemiology