A Snapshot of Prostate Cancer

Incidence and Mortality

Prostate cancer is the most common cancer, other than non-melanoma skin cancer, and the second leading cause of cancer-related death in men in the United States. African-American men have a higher incidence rate and at least twice the mortality rate compared with men of other racial/ethnic groups.

Prostate cancer incidence rates rose dramatically in the late 1980s, when screening with the prostate-specific antigen (PSA) test, which received initial U.S. Food and Drug Administration approval in 1986, came into wide use. Since the early 1990s, prostate cancer incidence has been declining. Mortality rates for prostate cancer also have declined since the mid-1990s.

Well-established risk factors for prostate cancer include increasing age, African ancestry, and a family history of prostate cancer. Current evidence suggests that screening with a digital rectal exam (DRE) and/or PSA has at most only a small effect on prostate cancer mortality. Standard treatments for prostate cancer include watchful waiting or active surveillance, surgery, radiation therapy, hormone therapy, chemotherapy, and biological therapy.

It is estimated that approximately $11.9 billion¹ is spent each year in the United States on prostate cancer treatment.

Trends in NCI Funding for Prostate Cancer Research

The National Cancer Institute's (NCI) investment² in prostate cancer research increased from $296.1 million in fiscal year (FY) 2007 to $300.5 million in FY 2010 before decreasing to $288.3 million in FY 2011. In addition to this funding, NCI supported $68.4 million in prostate cancer research in FY 2009 and 2010 using funding from the American Recovery and Reinvestment Act (ARRA).³

Examples of NCI Activities Relevant to Prostate Cancer

• The Prostate, Lung, Colorectal, and Ovarian Cancer (PLCO) Screening Trial, a large-scale clinical trial, is determining whether specific cancer-screening tests reduce deaths from these cancers. For prostate cancer, trial results have shown that annual screening with DRE and a PSA blood test did not reduce prostate cancer mortality.
• The Prostate Cancer Modeling project, conducted by the Cancer Intervention and Surveillance Modeling Network (CISNET), explores the natural history of prostate cancer, screening efficacy, screening policy, overdiagnosis, novel biomarkers, outcomes of care, and health disparities in prostate cancer screening and treatment.
• The Prostate Cancer Program includes staff from NCI's Medical Oncology, Radiation Oncology, and Urologic Oncology branches who conduct clinical training, clinical research, and clinical care to improve the management of patients with prostate cancer.
• The Tumor Microenvironment Network (TMEN) is exploring the role of the microenvironment—the cells and blood vessels that feed a tumor—in tumor initiation and progression. TMEN investigators are studying how prostate cancer cells traffic to and form metastases in the bone marrow.
• A new therapeutic cancer vaccine, sipuleucel-T (Provenge), was developed with substantial input from the National Cooperative Drug Discovery Group Program and has been approved for use in some patients with metastatic prostate cancer. The vaccine, which is custom-made for each patient, boosts immune response to the tumor and slows its growth.
• Nine prostate-cancer-specific Specialized Programs of Research Excellence (SPOREs) work collaboratively to conduct scientific studies for the clinical evaluation of biomarkers and early-phase clinical trials of anti-prostate cancer agents and to develop inter-institutional systems to accelerate prostate cancer research.

Selected Advances in Prostate Cancer Research

• Data from a randomized clinical trial of vitamin E and selenium for prostate cancer prevention indicate that taking vitamin E supplements increases prostate cancer risk among healthy men. Published October 2011. [PubMed Abstract]
• Results from 13 years of followup of the PLCO trial showed that annual screening using PSA testing and DRE had no effect on mortality compared with usual care. Published January 2012. [PubMed Abstract]
• NCI researchers carried out a small early-phase clinical trial of a new treatment approach for metastatic castration-resistant prostate cancer that combines immunotherapy to block a negative regulator of the immune system with a cancer vaccine that targets PSA. Published February 2012. [PubMed Abstract]
• Researchers identified molecular markers that may define a subgroup of men with bone metastatic prostate cancer that need a distinct form of treatment. Published February 2012. [PubMed Abstract]
• See this PubMed list of selected free full-text journal articles on NCI-supported research relevant to prostate cancer. You can also search PubMed for additional scientific articles.