Prostate cancer cases expected to double worldwide between 2020 and 2040, new analysis suggests

The Lancet Commission on prostate cancer warns of a looming crisis, projecting a doubling of cases to 2.9 million annually by 2040, with low- and middle-income countries (LMICs) facing the highest increases. Globally, we expect an 85% rise in deaths, primarily in LMICs due to underdiagnosis and missed data collection opportunities. Ageing populations and unavoidable risk factors contribute to the surge, demanding immediate action.

Lead author Professor Nick James emphasises evidence-based interventions, advocating for improved early detection and education programs. In high-income countries (HICs), the current approach to prostate cancer diagnosis may lead to over-testing, highlighting the need for MRI scans alongside PSA testing. However, we urgently need early detection programmes in LMICs, where most men present with advanced disease.

The Man Van trial in the UK demonstrates the efficacy of outreach programmes in detecting prostate cancer early. Similar initiatives could benefit LMICs, necessitating a global focus on men's health.

Raising awareness of advanced prostate cancer and available therapies is crucial, especially in LMICs where public awareness is low. Digital technologies and community engagement can aid education efforts, as seen in initiatives like Project Pink Blue in Nigeria.

Professor James N'Dow underscores the economic and social impacts of rising prostate cancer cases in LMICs and calls for investments in early diagnosis programmes to mitigate these harms.

Capacity building for diagnosis and treatment in LMICs is essential, requiring investment in specialist staff and infrastructure. Regional hubs could support specialist training and improve patient access to treatment.

Lastly, to ensure equitable outcomes for all populations, more research on ethnic disparities in prostate cancer care is necessary. Mandatory ethnicity recording in clinical trials and trials reflective of population diversity are essential steps in this direction.