Prostate cancer is the most diagnosed cancer among males in the U.S., but its progression varies widely, with some cases remaining harmless and others turning deadly. In recent years, concerns have grown over a rise in advanced prostate cancer, potentially linked to changes in screening recommendations. A recent study found that in California—a racially, ethnically, and geographically diverse state—the incidence of advanced-stage prostate cancer increased by nearly 7% over the past decade, while death rates, which had been declining, leveled off.

Researchers analyzed data from nearly 388,000 prostate cancer cases diagnosed in California between 2004 and 2021. Using data from state and national cancer registries, they examined trends in incidence and death rates based on cancer stage, age, race, ethnicity, and geographic region. They used statistical models to measure how these rates changed over time, focusing on patterns before and after shifts in screening guidelines.

They found that between 2011 and 2021, cases of advanced-stage prostate cancer increased by an average of 6.7% per year, with similar trends across racial and ethnic groups and nearly all regions of California. Meanwhile, prostate cancer death rates declined by 2.6% per year from 2004 to 2012 but remained steady through 2021, marking an end to previous declines in deaths from the disease.

These findings suggest that more men in California are being diagnosed with advanced prostate cancer, and the progress in reducing deaths has stalled. The gold standard for prostate cancer screening is the prostate-specific antigen (PSA) test. The U.S. Preventive Services Task Force recommends PSA screening for prostate cancer in men aged 55 to 69, but only among those at high risk for the disease. This screening can potentially reduce death but also carries risks such as false positives and treatment complications, including incontinence and erectile dysfunction. For men 70 and older, PSA screening is not recommended due to the greater likelihood of harms outweighing benefits.

Sulforaphane, a bioactive compound derived from broccoli, may reduce the risk for some types of cancer, including prostate cancer. Learn more in this episode featuring Dr. Jed Fahey.