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Prostate cancer is the most common cancer (other than skin cancer) diagnosed in men. In Indiana, 17,552 men were diagnosed with prostate cancer during the five year period from 1998 through 2002, giving an incidence rate of 136.3 per 100,000 per year*. Of the 70,631 cancers diagnosed in Indiana men from 1998-2002, about 25% were prostate cancer. Prostate cancer is many times more common than other cancers of the male reproductive system, e.g., testicular cancer, which had an average incidence rate of 5.4 during 1998-2002.
The incidence of prostate cancer increases with age. In Indiana, essentially no cases of prostate cancer were diagnosed before age 35 during 1998-2002. The age specific incidence rate increased from 0.6 for ages 35-39 to 866.4 for men aged 70-74. In contrast, testicular cancer is most commonly diagnosed between the ages of 20 and 45.
The vast majority of men diagnosed with prostate cancer will not die of the disease. Nevertheless, prostate cancer is the second leading cause of cancer death for men. In Indiana, 3,406 men died of prostate cancer from 1998-2002. The mortality rate averaged 31.6 during that time period.
Though the incidence rate for prostate cancer in Indiana 136.6 was lower than the national rate (173.8), the mortality rate (33.1) was slightly higher than the national rate (30.3). One explanation for the difference is that screening for prostate cancer may be lower in Indiana than in the rest of the nation. This explanation is supported by information from the Behavioral Risk Factor Surveillance System (BRFSS) for both 2002 and 2004. In 2004, 48.9% of Indiana men over age 40 reported having a Prostate Specific Antigen (PSA) blood test** within the past 2 years versus 52.1% of men = 40 years nationwide who reported having a PSA in the previous 2 years. Indiana's reported screening rate was lower than rates for 2/3 of the other states and the District of Columbia. However, though increased screening with the PSA will detect more early cases of prostate cancer, it is not yet certain that early detection of prostate cancer decreases mortality for the men diagnosed.
African American men bear a disproportionate share of the burden of prostate cancer. The 1998-2002 Indiana incidence rate for African American men over 40 years old was 209.2, compared to a rate of 130.4 for white males. Similarly, the mortality rate for African American men (73.6) is more than twice as high as that of white men in Indiana (29.2). The 2002 Indiana Health Behavior Risk Factors Report indicates that only 48.5% of Indiana black males over 40 reported having ever had a PSA versus 57.1% of white males. Almost 75% of prostate cancer cases are diagnosed at the local stage. However, black men are less likely to be diagnosed at the local stage than are white men (71.0% versus 75.7%), and black men are also almost twice as likely to be diagnosed at the distant stage as are white men (9.0% versus 4.9%).
* All rates are age-adjusted to the 2000 US standard population and are given per 100,000 population.
** An elevated PSA indicates the presence of one of several possible diseases of the prostate gland, including prostate cancer.
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