Prostate cancers overtake lung cases in men for first time
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Your support makes all the difference.Prostate cancer has become the most common cancer in men, replacing lung cancer in top position, according to the Office for National Statistics.
The switch occurred in 1999; figures released yesterday show there were 20,842 new cases of prostate cancer and 19,243 new cases of lung cancer in that year.
Last May, the Institute of Cancer Research predicted that cases of prostate cancer would overtake those of lung cancer within three years, unaware that that had already occurred. Most of the increase is due to a test that detects early signs of the disease.
The number of new cases of lung cancer has declined continuously to a quarter of the figure of the late 1970s, reflecting the decline in smoking 30 years earlier. Prostate cancer rose steadily during the 1970s and 1980s by 4 per cent a year but surged by 50 per cent between 1990 and 1996.
Although prostate cancer is now more common, lung cancer is more deadly. Prostate cancer claims 9,500 lives a year, lung cancer 33,700.
Prostate cancer has been described as the only curable cancer that may not need treatment. A US study published in The New England Journal of Medicine this month showed that there was no difference in overall death rate between men with prostate cancer who had surgery and those who opted for "watchful waiting".
Prostate cancer is more common in the United States where the prostate specific antigen (PSA) test for detecting the disease is more widely used. The more men are tested, the more cases are detected, but about 70 per cent do not need treatment.
Surgery carries risks, including impotence and incontinence, but despite the rapidly rising incidence of prostate cancer, doctors still lack a way of telling which men require treatment for aggressive forms of the disease.
Dr Richard Sullivan, the head of clinical programmes for Cancer Research UK, said the figures were not "surprising" because campaigns had reduced the appeal of smoking and the PSA test had highlighted cases of prostate cancer.
Dr Sullivan said: "There's no real increase in the number of prostate cancer cases. It's just that the number of people asking for the PSA test has increased, enabling us to highlight more cases."
The Institute for Cancer Research is running a trial in collaboration with the Royal Marsden Hospital, in Surrey that is aimed at developing new means of managing the disease.
In the absence of a laboratory test that can identify men with the aggressive form of the disease, doctors are instead offering patients with raised levels of PSA a programme of "active surveillance" with regular examinations and a biopsy of the prostate gland every two years, in which a sample of tissue is taken for examination. Only if the PSA level rises rapidly will surgery be undertaken.
Fast-growing tumours will be studied to try to identify a marker that would show if a tumour was life threatening.
Doctors complain, however, that funding for prostate-cancer studies is so hard to come by that research is 10 years behind that into other cancers.
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