Dr. Cookson on 2023 ACS prostate cancer data


“We need to do better, and men in America deserve a better chance at long-term, good outcomes from their prostate cancer discovery,” says Michael S. Cookson, MD, MMHC.

In this video, Urology Times® Co–Editor in Chief Michael S. Cookson, MD, MMHC, discusses data from the Cancer Statistics, 2023 report from the American Cancer Society. Cookson is professor and chair of urology at the University of Oklahoma Health Sciences Center in Oklahoma City.

Cookson: The American Cancer Society just released their Facts and Figures for the United States. There was good news, such as overall reductions in deaths from different cancers. Some big strides were made in cervical cancer that were probably due to vaccinations; they're starting to see the fruits of their labor there. That's great news. But for men's health, and when it comes to prostate cancer, the news wasn't that good. About a third of all incident cancers, 288,000+, diagnosed this year will be prostate cancer, and unfortunately, over 34,000 deaths. The incidence of prostate cancer, of course, is much higher in Black men as compared with White men. There was a period of time back in the 1990s to early 2000s where we actually saw a pretty good reduction in deaths from prostate cancer, and we moved to number 3 on the list, and we wanted to move even further down. Unfortunately, now we're back up to number 2 in deaths, and we've seen an increase in deaths. We're also seeing much higher detection of more advanced and metastatic disease. This can only really be due to a couple of factors, and one of them is that there's just no good national consensus on screening. When you have lobbying from different factions and concerns over overtreatment and harms of treatment, then you run into problems. That's really what we're seeing. If we detect prostate cancer at an early stage, sometimes treatment isn't needed. But if treatment is needed, especially for those high-grade tumors, it can be curative. And although we've made great strides in the treatments available for men with advanced disease, we're not curing those men. We can prolong their survival, we can improve their quality of life, but we can't cure them. That's really disappointing. I think we need to really readdress our screening strategies, get into discussions with men's families, and get them in for screening at a very early stage. When we're talking about average-risk patients, it's probably somewhere around age 50 to 55. But when you're talking about Black men, men with a family history, you want to move that back to around, say, 45 to 50, and if you have a genetic predisposition to somewhere around age 40. If we don't get that initial PSA screening and get them discovered early, we're going to miss that opportunity for cure. What we're seeing are the unfortunate consequences of anti-screening campaigns. We need to do better, and men in America deserve a better chance at long-term, good outcomes from their prostate cancer discovery.

This transcript has been edited for clarity.

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