The American Cancer Society?s 2023 Cancer Statistic Report Highlights Urgency to Address the Prostate Cancer Crisis
by Thomas Farrington
PHEN President and Founder
The prostate cancer crisis as defined by the American Cancer Society’s (ACS) 2023 Cancer Statistics Report is not a surprise for those of us that have been on the forefront of the prostate cancer early detection screening debate during the past decade. We predicted this crisis when the “stop screening” edict came down from the U.S. Preventive Services Task Force (USPSTF) in 2012. In addition, PHEN has consistently pointed out that Black men would suffer the most. At our 18th Annual African American Prostate Cancer Disparity Summit in September, 2022, PHEN presented the alarming data trends that are included within the ACS report. The challenges before us today are to identify and implement, with urgency, effective approaches to turn the tide on the prostate cancer crisis.
I was really delighted that ACS chose to present its 2023 Cancer Statistics Report at Howard University, (a Historically Black University), and to simultaneously announce its new initiative, IMPACT (Improve Mortality from Prostate Cancer Together). ACS’s CEO Dr. Karen Knudsen is to be applauded for her vision and leadership for undertaking this effort to reduce prostate cancer disparities and deaths from prostate cancer for all men. PHEN was honored to be a part of the announcement for this groundbreaking initiative and we are committed to doing everything that we can to support it.
However, we must not accept that this positive action by ACSs lead will resolve the prostate cancer crisis. We should view it as a call-to-action and follow ACS with additional bold and creative initiatives. First, we must get beyond the early detection screening conundrum. Resolving this issue is paramount to solving the prostate cancer crisis.
As an advocate for patients and men at risk for prostate cancer, I am urging those organizations that issue prostate cancer screening guidelines to collaborate to formulate a uniform guidance that breaks through today’s confusion. These organizations include the ACS, USPSTF, AUA (American Urological Association), NCCN (National Comprehensive Cancer Network). I am including the AAFP (American Academy of Family Physicians) because of the overwhelming influence that primary care physicians have on early detection screening. They are the first line of defense against prostate cancer.
When the USPSTF announced its 2012 recommendation to stop screening it received broad national press coverage, and it did indeed stop most primary care physicians from providing early detection screening, or even discussing it with their patients. The USPSTF updated its recommendation in 2018 but the change has not flowed through impactfully.
Major concerns that prompted the USPSTF’s 2012 recommendation included the over-diagnoses and over-treatment of men with prostate cancer who might suffer more from the treatment than the cancer itself. In 2023 these concerns have been addressed through new technologies, practices for performing biopsies, and treatment of low-risk disease with active surveillance.
I serve on both the NCCN’s early detection and treatments guideline panels, and know first-hand the work that has gone into developing these guidelines to address the concerns that led to the 2012 recommendation. I know that other guideline organizations have put in this work as well. As a patient representative I am comfortable with where we are today with new technologies, therapies and practices for patients. However, I am most concerned that decisions about early detection screening are still based, to a great extent, on the 2012 realities and not the realities of 2023, and this is driving the current prostate cancer crisis.
A joint announcement in 2023 of clear and uniform prostate cancer early detection screening guidance will remove confusion and serve as a catalyst to help turn the tide on the prostate cancer crisis.
