Prostate Cancer Incidence by Stage at Diagnosis

Introduction

Aside from non-melanoma skin cancer, prostate cancer was the most common cancer among men in 2021. That year, 6% of prostate cancer cases were diagnosed among men aged 45 to 54 years , 52% among men aged 55 to 69 years, and 42% among men aged 70 years or older.

From 2001 to 2021, prostate cancer incidence was highest among men aged 70 years or older. In 2021, the incidence rate was 586 per 100,000 males. Rates dropped in 2020 due to disruptions in cancer screening, diagnosis, and care caused by the COVID-19 pandemic. Rates in 2021 were higher than in 2020 but lower than expected based on past trends. Overall, and among men age 55 years or older, rates decreased from 2007 to 2014 and increased from 2014 to 2021.

Figure 1. Trends in prostate cancer incidence^a by age, all stages,^b United States, 2001–2021^c

Note: The y-axis does not start at 0.

Incidence trends by stage at diagnosis

This analysis used SEER Summary Stage to code stage at diagnosis as localized, regional, distant, or unknown:

• Localized cancer is confined to the primary site.
• Regional cancer has spread directly beyond the primary site (regional extension) or to regional lymph nodes.
• Distant cancer has spread to other organs (distant extension) or remote lymph nodes.
• Some cancers are unstaged or the stage is unknown or unspecified.

From 2017 to 2021, 70% of prostate cancer cases were found at a localized stage, 14% at a regional stage, and 8% at a distant stage.

The incidence of prostate cancer declined from 2001 to 2021, with some changes from year to year and by stage at diagnosis. For localized stage, rates decreased from 2001 to 2021 (while rates changed during this period, changes in trend were not statistically significant). Rates for regional stage were stable from 2001 to 2010, decreased from 2010 to 2013, and increased from 2013 to 2021. Rates for distant stage were stable from 2003 to 2011 and increased from 2011 to 2021. Some changes in incidence by stage may correspond to changes in the staging schema, screening recommendations, and use of the prostate-specific antigen (PSA) test.

Figure 2. Trends in prostate cancer incidence^a by stage at diagnosis,^b United States, 2001−2021^c

Note: The y-axis does not start at 0.

Screening recommendations

The U.S. Preventive Services Task Force updated its prostate cancer screening recommendations in 2018. Men should talk to their doctor about the benefits and harms of screening for prostate cancer.

Data source

Data in this brief come from U.S. Cancer Statistics, the official federal cancer statistics. U.S. Cancer Statistics incidence data are from population-based registries that participate in CDC's National Program of Cancer Registries (NPCR) and the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) Program. Data submitted in 2023 that met publication standards for the 2001–2021 period covered 97% of the U.S. population (excluding data from Indiana and Mississippi).

Footnotes

^a Rates are per 100,000 standard male population and are age-adjusted to the 2000 U.S. standard population. The joinpoint regression model did not include 2020 incidence points in the fit of the trend lines.

^b Cases diagnosed only by autopsy or death certificate were excluded from analysis.

^c The 2023 data submission, released in June 2024, includes new cancer cases diagnosed in 2020 and 2021, the first and second years of the COVID-19 pandemic. The missed cancer diagnoses resulting from disruptions in health services caused by the pandemic may have contributed to an observed decline in incidence for most cancer sites in 2020. The numbers of new cases diagnosed in 2021 are still a little lower than expected for some cancer types but have returned to pre-pandemic counts for other cancer types. Caution must be taken when examining trends to avoid incorrect interpretations of the effect of cancer prevention and early detection efforts. Observed downward trends may be due largely to the lower observed incidence in 2020.