A report published today by the National Cancer Registry (Cancer Trends. No. 3. Recent trends in prostate cancer) shows that the number of new cases of cancer of the prostate has increased from 1492 in 1999 to 2758 in 2009, a rise of 85%. In men aged 55-64 the number of cases more than doubled.

In contrast, between 1996 and 2006 the number of deaths from prostate cancer increased only slightly, from 523 to 543, while the risk of dying of the cancer before the age of 75 has actually fallen, from 0.9% to 1.4%. The slight increase in deaths is due to the increasing numbers of older men in the population. The prostate cancer death rate in Ireland remains high by international standards, being third only to those in Norway and Sweden.

Commenting on the figures, Dr Harry Comber, Director of the National Cancer Registry, said “The dramatic increase in prostate cancer rates is almost certainly due to the five-fold increase in PSA tests between 1995 and 2004”. “However”, Dr Comber said, “the fall in prostate cancer mortality preceded the widespread use of PSA testing and does not seem to be related to it.”

Other findings in the report are that

• Although the numbers of early cancers have gone up considerably, there has been no corresponding fall in the number of late stage cancers;
• About 80% of patients had some form of active treatment for their cancer (i.e. surgery, radiotherapy or hormonal) and this remained constant between 1994 and 2008;
• The use of radiotherapy for prostate cancer doubled between 1994 and 2008, while the use of most other treatments remained constant or declined.

A copy of the report is on the National Cancer Registry website.

Further information about PSA testing and prostate cancer in Ireland can be found in:

Trends in prostate specific antigen testing in Ireland: lessons from a country without guidelines. Drummond FJ, Carsin AE, Sharp L, Comber H. Ir J Med Sci. 2010 179(1):43-9

and

Impact of PSA testing and prostatic biopsy on cancer incidence and mortality: comparative study between the Republic of Ireland and Northern-Ireland. A-E Carsin, F J Drummond, A Black, P.J van Leeuwen, L Sharp, LJ Murray, D Connolly, L Egevad, M Boniol, P Autier, H Comber, A Gavin. Cancer Causes and Control, in press.