- Prostate cancer rates rose over the past decade, following years of decline.
- The increase is driven by advanced prostate cancer diagnoses, even in males as young as 55.
- Experts say it’s time to reevaluate recommendations for PSA screening to ensure prostate cancer is caught early.
Prostate cancer rates have risen steadily over the past decade, reversing course after years of decline.
Diagnoses of prostate cancer rose by 3% annually between 2014 and 2021, following year-over-year declines of 6.4% in the late 2000s and early 2010s, according to the
Even more worrisome, the growth is driven by late-stage cancer diagnoses, the most dangerous form, in which the cancer has spread to other parts of the body. Advanced prostate cancer increased by up to 6.2% annually, with the most precipitous increase observed in males over the age of 70.
Prostate cancer is the second-leading cause of cancer-related death for men in the United States, second only to lung cancer. One in eight men will be diagnosed with prostate cancer during their lifetime. In 2025, the ACS estimates 313,780 new cases of prostate cancer and 35,770 deaths from the disease.
Declines in mortality have also slowed. Between 1993 and 2012, deaths from prostate cancer fell about 3.5% per year, before slowing to a trickle — just 0.6% per year during the following decade.
For males ages 55–59, USPTF guidelines remain a “C” score, stating that periodic screening can be considered.
“It appears that we are still experiencing some of the detrimental effects of the USPSTF recommendations against PSA screening, as we continue to see an increase in distant-stage disease across age groups,” said Jeffrey Tosoian, MD, MPH, an assistant professor of urology and director of Translational Cancer Research at Vanderbilt University Medical Center. Tosoian was not involved in the research.
“The hope is that as updated recommendations based on best-available evidence take hold, this trend will reverse, and the harm caused by prostate cancer can be significantly reduced,” he told Healthline.
The report highlights in stark detail consistent disparities in prostate cancer diagnosis and treatment due to race and ethnicity.
Black men have the highest incidence rate of prostate cancer of all racial or ethnic groups — 67% higher than white men. They experience higher rates of the disease at every age compared to white men, and have the lowest age of diagnosis (65 years old) out of all racial groups.
Black men also fare significantly worse disease outcomes than their peers: they are twice as likely to die from prostate cancer as any other racial or ethnic group.
“Though this disparity has improved from a 2.5-fold increase in 2001, it underscores the importance of ensuring equal access to quality healthcare, among other potential factors,” said Tosoian.
Disparities in mortality are present in other groups as well. For example, despite overall lower incidence of prostate cancer among American Indian and Alaska Natives (AIAN), they have a 12% higher mortality rate than White men.
The reason for these disparities is multifactorial and includes factors like:
- later stage diagnosis
- higher prevalence of comorbidities
- barriers to receiving high-quality treatment
“Improving access to care, particularly early detection and high quality treatment, is important for reducing the disparity for Black men,” said
“Prior research has shown that when Black men and white men with similar prostate cancer are treated equally, they have equivalent outcomes,” Kratzer told Healthline.
Kratzer and his team also identified significant geographic prostate cancer trends in the United States, which may also be driven by racial disparities. They note that Washington, DC, and Mississippi, the two jurisdictions with the highest death rates from prostate cancer, also have higher proportions of Black residents.
The ACS report suggests that climbing prostate cancer incidence rates, particularly at later stages, may be the result of
PSA screening is a simple blood test that measures prostate-specific antigen (PSA) levels. PSA is naturally produced by the prostate gland, but elevated levels may indicate the presence of cancer. PSA testing can detect prostate cancer up to 7 years before it becomes symptomatic.
Despite these benefits, screening is also associated with
How to strike a balance between the harms and benefits of PSA testing is the “central question in the field” according to Tosoian.
In 2018, the USPSTF again
For patients, navigating these vague recommendations may be difficult.
“The recommendations certainly can be inconsistent from one guideline to the next, yet the majority of them are aligned on major points,” said Tosoian.
“Men with a life expectancy of 10 years or more should consider PSA screening to avoid long-term risk of harm from prostate cancer. The exact age at which guidelines recommend beginning to screen does vary among guidelines, but most agree on beginning in the range of 45 to 55,” he said.
Kratzer suggested that having informed discussions with family members and healthcare practitioners is essential for anyone considering prostate cancer screening.
“Patients should talk with their family members to learn about any history of prostate cancer and then have a conversation with their healthcare provider about if and when screening is in their best interest, beginning at age 50 for most men or earlier for those with higher risk,” he said.
