The Lancet Commission on prostate cancer: planning for the surge in cases

Key messages

• •We project that the number of new cases of prostate cancer annually will rise from 1·4 million in 2020 to 2·9 million by 2040. Changing age structures and improving life expectancy are predicted to drive big increases in the disease.
• •The projected rise in prostate cancer cases cannot be prevented by lifestyle changes or public health interventions.
• •Late diagnosis of prostate cancer is widespread worldwide but especially in LMICs, where late diagnosis is the norm. The only way to mitigate the harm caused by rising case numbers is to urgently set up systems for earlier diagnosis in LMICs. Trials of screening are urgently needed in LMICs to better inform ways to improve early diagnosis.
• •Early diagnosis systems will need to incorporate novel mixes of personnel and integrate the growing power of artificial intelligence to aid interpretation of scans and biopsy samples.
• •As the rise in prostate cancer is likely to be mirrored by rises in other conditions such as diabetes and heart disease, early diagnosis programmes should focus not just on prostate cancer but on men’s health more broadly.
• •Outreach programmes are needed that harness the broad global availability of smartphones as tools for education about prostate cancer (using both social media and traditional media), as are programmes that assist people with navigation of health-care systems.
• •Most prostate cancer research has disproportionally focused on men of European origin, despite rates of prostate cancer being twice as high in men of African heritage. Better understanding of drivers of ethnic differences in prevalence of the disease is a key research priority.
• •Treatment of advanced prostate cancer remains a problem, and affordable therapies are available but are unevenly distributed. Consistent use of these therapies is a cost-effective way to reduce harm from prostate cancer.
• •There remains a shortage of specialist surgeons and radiotherapy equipment in LMICs, and addressing this shortage is key to improving prostate cancer care globally.

Further information – The Lancet Commission on prostate cancer: planning for the surge in cases