title: Trends in United States Prostate Cancer Incidence Rates by Age and Stage, 1995-2012.
abstract: BACKGROUND
  The advent of PSA testing in the late 1980s substantially increased prostate cancer incidence rates. Concerns about overscreening and overdiagnosis subsequently led professional guidelines (circa 2000 and later) to recommend against routine PSA testing. We evaluated trends in prostate cancer incidence, including late-stage diagnoses, from 1995 through 2012.
  
  
  METHODS
  We used joinpoint regression analyses to evaluate all-, localized/regional-, and distant-stage prostate cancer incidence trends based on Surveillance, Epidemiology, and End Results (SEER) data. We stratified analyses by age (50-69, 70+). We reported incidence trends as annual percent change (APC).
  
  
  RESULTS
  Overall age-adjusted incidence rates for localized/regional stage prostate cancer have been declining since 2001, sharply from 2010 to 2012 [APC, -13.1; 95% confidence intervals (CI), -23.5 to -1.3]. Distant-stage incidence rates have declined since 1995, with greater declines from 1995 to 1997 (APC, -8.4; 95% CI, -2.3 to -14.1) than from 2003 to 2012 (APC, -1.0; 95% CI, -1.7 to -0.4). Distant-stage incidence rates declined for men ages 70+ from 1995 to 2012, but increased in men ages 50 to 69 years from 2004 to 2012 (APC, 1.7; 95% CI, 0.2 to 3.2).
  
  
  CONCLUSIONS
  Guidelines discouraging routine prostate cancer screening were temporally associated with declining localized/regional prostate cancer incidence rates; however, incidence rates of distant-stage disease are now increasing in younger men.
  
  
  CONCLUSIONS
  This trend may adversely affect prostate cancer mortality rates.
authors.affiliation: Department of Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa. Holden Comprehensive Cancer Center, University of Iowa, Iowa City, Iowa. richard-m-hoffman@uiowa.edu.
authors.forename: Richard M
authors.initials: RM
authors.lastname: Hoffman
authors.affiliation: University of New Mexico Comprehensive Cancer Center, Albuquerque, New Mexico.
authors.forename: Angela L W
authors.initials: AL
authors.lastname: Meisner
authors.affiliation: University of New Mexico Comprehensive Cancer Center, Albuquerque, New Mexico. Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico.
authors.forename: Wadih
authors.initials: W
authors.lastname: Arap
authors.affiliation: University of New Mexico Comprehensive Cancer Center, Albuquerque, New Mexico. Department of Pathology, University of New Mexico, Albuquerque, New Mexico.
authors.forename: Marc
authors.initials: M
authors.lastname: Barry
authors.affiliation: University of New Mexico Comprehensive Cancer Center, Albuquerque, New Mexico. Department of Surgery, University of New Mexico, Albuquerque, New Mexico.
authors.forename: Satyan K
authors.initials: SK
authors.lastname: Shah
authors.affiliation: Puget Sound VA Healthcare System, Seattle, Washington.
authors.forename: Steven B
authors.initials: SB
authors.lastname: Zeliadt
authors.affiliation: University of New Mexico Comprehensive Cancer Center, Albuquerque, New Mexico. Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico.
authors.forename: Charles L
authors.initials: CL
authors.lastname: Wiggins
mesh_terms: D000367:Age Factors; D000368:Aged; D055088:Early Detection of Cancer; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011471:Prostatic Neoplasms / Q000453:epidemiology*; D018426:SEER Program; D014481:United States