Prostate Cancer Prevention Policy
Prostate cancer in Australia
Incidence and mortality
Prostate cancer is the most common cancer diagnosed in men and the most common cancer diagnosed in Australia (apart from keratinocyte cancers). In 2016, 19,305 prostate cancer cases were diagnosed in Australia. One in six Australian men are likely to be diagnosed with prostate cancer by the age of 85.
In 2018, prostate cancer was the cause of 3,264 deaths. It is the second most common cause of cancer death in Australian men after lung cancer. The ratio of prostate cancer mortality compared with incidence (deaths divided by new cases per year) is low compared with most other cancers. The number of new cases recorded in 2016 was six times the number of deaths.
Age-standardised incidence rates for prostate cancer have increased from 31.2 cases per 100,000 males in 1982 to 67.3 cases in 2016 (See Figure 1). Between 1982 and 2018, age-standardised mortality rates have reduced from 12.7 deaths per 100,000 males to 10.2 deaths (See Figure 1). The increased incidence is thought to reflect an increase in detection of prostate cancer rather than a true increase in incidence, as the rise closely followed the increasing use of prostate-specific antigen (PSA) testing for the disease.
It is likely that PSA testing uncovered a large pool of undiagnosed, asymptomatic prostate cancer cases that may not otherwise have been diagnosed until symptoms developed, or may never have been diagnosed.  While the fall in prostate cancer mortality might indicate a beneficial effect of PSA testing, it is also likely to be attributable to improvements in treatment.
Increases in PSA testing and screening have been accompanied by an increase in hospital admissions and in prostatectomies and other treatments (e.g. radiotherapy) for prostate cancer. See Economic impact, below.
Figure 1. Trends of prostate cancer incidence and mortality in Australian men 1982-2020, rate per 100,000 men
Source: Australian Institute of Health and Welfare. Cancer data in Australia
Impact in relation to age
Prostate cancer mainly affects older men; it becomes more common as men age. More than 80% of men diagnosed with prostate cancer were aged over 60, and 60% of prostate cancer deaths occur in men over the age of 80.
Similarly, numbers of prostate cancer deaths increase significantly with age. Over 98% of men who died of prostate cancer in 2018 were aged over 60. Of the 68 deaths in Australian men under 60, four occurred in men under 50.
Many prostate cancers grow slowly, so men who are older than 75 years or who have less than 10 years’ life expectancy at diagnosis of prostate cancer are more likely to die of other causes than of the cancer. Therefore, men diagnosed with prostate cancer at an earlier age (e.g. in their 50s) are more likely to die from prostate cancer than men who were older at diagnosis.
On the most recent national data available, prostate cancer is the most expensive cancer in men in Australia, and the third most expensive overall. In 2008-09, health system expenditure on prostate cancer was $347 million, accounting for almost 8% of all health system expenditure on cancer. Of this, $195 million was for hospital inpatient costs, $122 million for prescription pharmaceuticals and $30 million for out of hospital costs..
A state-based analysis by Access Economics estimated the total lifetime cost of prostate cancers diagnosed in New South Wales in 2005 was approximately $2.2 billion. This amount included $297 million in health system and other financial costs (including lost productivity) and $1.9 billion in lost wellbeing and premature death.
- Australian Institute of Health and Welfare. Cancer data in Australia. [homepage on the internet] Australian Institute of Health and Welfare; 2020 [cited 2021]. Available from: https://www.aihw.gov.au/reports/cancer/cancer-data-in-australia/contents/summary.
- Australian Institute of Health and Welfare. Cancer Australia 2018: Mortality-to-incidence ratio. [homepage on the internet] Canberra: Australian Institute of Health and Welfare; 2018 [cited 2021]. Available from: https://www.aihw.gov.au/getmedia/3da1f3c2-30f0-4475-8aed-1f19f8e16d48/20066-cancer-2017.pdf.aspx?inline=true.
- Australian Institute of Health and Welfare. Key indicators of progress for chronic disease and associated determinants: data report. Canberra: AIHW; 2011 Jun. Report No.: Cat. no. PHE 142. Available from: http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=10737419243&libID=10737419242.
- Australian Institute of Health and Welfare, Australasian Association of Cancer Registries. Cancer in Australia: an overview, 2006. Canberra: AIHW; 2007. Report No.: Cancer series no. 37. Cat. no. CAN 32. Available from: http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=6442454559.
- Smith DP, Supramaniam R, Marshall VR, Armstrong BK. Prostate cancer and prostate-specific antigen testing in New South Wales. Med J Aust 2008 Sep 15;189(6):315-8 Available from: http://www.ncbi.nlm.nih.gov/pubmed/18803534.
- Baade PD, Steginga SK, Pinnock CB, Aitken JF. Communicating prostate cancer risk: what should we be telling our patients? Med J Aust 2005 May 2;182(9):472-5 Available from: http://www.ncbi.nlm.nih.gov/pubmed/15865593.
- Australian Institute of Health and Welfare. Health system expenditure on cancer and other neoplasms in Australia 2008-09. Canberra: AIHW; 2013 Dec 16. Report No.: Cancer series 81. Cat. no. CAN 78. Available from: http://aihw.gov.au/publication-detail/?id=60129545611.
- Access Economics Pty Ltd. Cost of cancer in NSW. Sydney: Access Economics; 2007 Apr. Sponsored by Cancer Council NSW. Available from: http://www.cancercouncil.com.au/wp-content/uploads/2010/11/costofcancer_summary.pdf.