Movember 2023: Prostate Mortality Trends by Age Groups, Updates to 2022
Getting more granular on prostate cancer mortality trends
In my last prostate cancer mortality post, I looked at a high-level trend for mortality. In this one, I will break out by major age groups. But first….
Movember Fundraiser
First, here are the places you can donate to the Movember Foundation, which supports men’s health, specifically focusing on prostate cancer, testicular cancer, and men’s mental health:
Mary Pat Campbell’s MoSpace – a place to donate at Movember itself
My Movember Facebook fundraiser – my officially linked fundraiser, if this works better for you
And here’s a QR code if that works better for you:
Prostate Cancer Death Rates: Breakout by Age Groups
Like most natural causes of death, prostate cancer mortality grows rapidly with age. You can see how rapidly the separation grows, and you can see how much the trajectory overall has been driven at the older ages.
As I mentioned in prior years, much of the reduction in prostate cancer mortality occurred after the widespread adoption of PSA screening for men.
Decadal changes in prostate cancer mortality: recent stalling
However, to get a better grip on prostate cancer mortality trends, let’s look at the decade-to-decade change by age group.
In this graph, a positive bar is bad, meaning mortality rates increased. Negative bars are good, which means mortality rates went down.
Therefore, for most of these age groups, prior to 1992, we saw increases in prostate cancer mortality. Then, over the next 20 years, for most of the age groups, we saw substantial decreases in prostate cancer mortality. Amazing!
But from 2012-2022, we’ve seen a stalling out, and I have argued part of that came from a reversal in PSA screening recommendations.
Since 2011/2012, prostate cancer has been found at more advanced stages, because there has not been as broad prostate cancer screening for men, unlike other types of cancer screening, as with colon cancer.
Focus on the pandemic years: even worse news
Let’s see how prostate cancer mortality has evolved just since 2019.
I do throw in the age 45-54 year old age group, but that is a very low mortality rate to begin with. Happy to see this group doing fairly well.
But we can see the older age groups not doing quite so well — and these, of course, are the ones at higher risk to begin with.
I am wondering if they missed treatment, forget about missing screenings (though some may have missed screenings).
Stu’s Pandemic Experience
My husband Stuart never missed his appointments in White Plains, where his oncologist and cancer care team are, at Memorial Sloan-Kettering. For those who may have come to this post from elsewhere, my husband Stu was diagnosed with advanced prostate cancer in 2017, and his version is incurable but treatable. He is still alive (and stable, but at risk.)
However, Stu noticed that he was often the only person physically at the location for his treatments. He asked nurses about this, and was told that many people canceled appointments due to having COVID or other ailments, did telehealth visits (I wonder about that), had appointments at other locations other than the hospital, etc.
Many of the older patients (and Stu is about 20 years younger than the average advanced prostate cancer patient) need to have other people drive them, and many lost their rides, because their driver was a friend or relative or died from COVID, or because they were a paid driver who left for something more lucrative.
On top of that, there were issues of some pharmaceutical shortages.
So these are all potential sources of the increased prostate cancer mortality for the older ages in the pandemic. Note that for under age 65, where death rates are already low, improvement continued.
Let’s reverse the bad trend!
It remains to be seen where these trends go post-pandemic, but I’m not happy with what I saw even before 2019.
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