Definitive and sustained increase in prostate cancer metastases in the United States

Introduction: We examined the most recent Surveillance, Epidemiology, and End Results release to corroborate temporal trends in non-metastatic and distant prostate cancer metastases in the United States. Methods: Surveillance, Epidemiology, and End Results was analyzed for the incidence of nonmetastatic and distant metastasis for men with prostate cancer aged 50-74 and >= 75 years during 2004-2015. Incidence ratios (IR) were calculated relative to the year prior. Results: The incidence of distant metastasis significantly increased from 451.0 to 504.0 per million (IR:1.12, 95% CI:1.01-1.24) from 2011 to 2012 and 532.3 to 586.1 per million (IR: 1.10, 95% CI: 1.00-1.21) from 2014 to 2015 in men aged >= 75 years. The incidence of distant metastasis did not significantly increase in men aged 55-74 over the study period. Conclusion: We demonstrate a sustained and definitive increase in prostate cancer distant metastases in men aged >= 75 years. Although our observational study design cannot pinpoint the exact cause of this increase, which is likely multifactorial, this shift reverses declines in metastases at diagnoses that followed the advent of prostate-specific antigen screening. (C) 2019 Elsevier Inc. All rights reserved.