AHRQ study finds prostate cancer mortality rate declines by 45%

According to the U.S. Agency for Healthcare Research and Quality (AHRQ), compared to men in 1999, American men in 2006 that were fighting prostate cancer were 45% less likely to die from the disease. "There is no specific reason for this decline, but I believe early detection and prostate cancer treatment education and awareness are probably major factors," said Dr. David Samadi, a robotic surgery expert, as well as the new Vice Chairman, Department of Urology, and Chief of Robotics and Minimally Invasive Surgery at The Mount Sinai Medical Center in New York City.

While the death rate is steadily declining, prostate cancer is still the second leading killer in American men, and the outlook is still very grim. Roughly one out of six American men will receive a prostate cancer diagnosis in their lifetime. Countering the death rate decline is the number of new cases being diagnosed each year. In 2010, more than 218,000 new prostate cancer cases will be diagnosed, and over 32,000 will die from the disease.

The following results were seen in 100,000 males during the AHRQ study period:

• American men died from prostate cancer declined from 23.5 deaths to 13 deaths per 100,000 males during the period.
• African-American men were more than twice as likely to die from prostate cancer -- 69 to 50.5 deaths and 29 deaths to 22 deaths per 100,000 males during the study period, as compared to white men.
• The prostate cancer mortality rate for Hispanics and Asian-American Pacific Islanders went down from 23 to 18 and from 17 to 14, respectively, during the period.
• Men, age 65 and older, were 20% less likely to die from prostate cancer in 2006 as compared to 1999, with their mortality rate falling from 205 deaths to 164 deaths during the period.

Recently, a British Medical Journal reported stated that Prostate Specific Antigen (PSA) levels measured at age 60 are good predictors of a man's risk of dying from prostate cancer. "The PSA screening test is one of the best tools we have today for diagnostic purposes," said Dr. Samadi, a world-renowned prostate cancer surgeon. The current clinical practice believes that men with elevated levels of PSA are at higher risk of having prostate cancer.

PSA is produced by the prostate gland. When increased amounts are found in the blood, patients are referred for biopsies to check for prostate cancer. Regular PSA screenings can give doctors good indicators of the disease and allow them to begin prostate cancer treatments. "Therefore, patient education and PSA screening are very effective tools in the fight against prostate cancer," said Dr. Samadi.

Critics report that the over-treatment of prostate cancer results in $3 billion being spent each year. Needless to say, there is a sense of urgency to find funding to help physicians cure more and over-treat less. New legislation underway will hopefully discover improvements or alternatives to current prostate cancer screening tests and help create methods to distinguish between different types and stages of prostate cancer.

Still, Dr. Samadi sees prostate cancer research at a crossroad. "I have seen more progress in 2010 than I have in the past decade," he said, "But this only means we have to step things up in order to understand the behavior of the disease and individualize prostate cancer treatments to the patient." With more education, increased legislative efforts and research, this understanding can create a larger decline in the death rate from prostate cancer.