Recent trends in prostate cancer testing and incidence among men under age of 50

Background: Information on prostate cancer testing and incidence among men under age 50 is scant. This study aims to describe trends of prostate cancer testing and incidence by demographic and clinical characteristics and identify potential correlations between prostate cancer testing and incidence. Methods: We examined prostate cancer testing and incidence rates among American men under age of 50 using data from the Behavioral Risk Factor Surveillance System (2002, 2004, 2006, and 2008) and data from the National Program of Cancer Registries and Surveillance, Epidemiology, and End Results programs (2001–2006). We conducted descriptive, logistic regression, and trend analyses using SUDAAN and SEER*Stat. Results: The prostate cancer incidence rate among black men was more than 2-fold that of white men. The overall prostate cancer incidence rate slightly increased from 2001 to 2006; however, the prevalence of prostate cancer testing declined over time. There was a borderline significant increase in prostate cancer incidence rate (APC = 3.5, 95% CI = 0.0, 7.0) for men aged 40–44. Well-differentiated prostate cancer incidence decreased significantly (APC = −24.7; 95% confidence interval (CI) = −34.9, −12.8) over time. Conclusions: We observed a large difference in prostate cancer incidence between blacks and whites under age 50. Similar patterns in prostate cancer testing and cancer incidence by race and ethnicity suggested prostate cancer testing might have influenced incidence to some extent in this young population. The different temporal patterns for prostate cancer testing and incidence, especially for men aged 40–44 years, suggested screening alone could not fully accounted for the increasing prostate cancer incidence rates. Decreasing trend of well-differentiated prostate cancer may be partially due to “Grade Inflation”.