Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Prostate Cancer in Young Men: An Emerging Challenge

Key clinical point: Rates of prostate cancer in older adolescent and young adult men had an increase in most major countries, possibly due to under and overdiagnosis, and specific antigen screening, or even trends in obesity, inactivity, substance exposure, environmental carcinogens, HPV infection, and/or referral patterns.

Major finding: The incidence of prostate cancer has increased in all groups between ages 15 - 40 years and increased at a steady rate averaging 2% per year since 1990, worldwide.

Study details: Data on incidence, mortality, and survival were obtained from the US National Cancer Institute Surveillance, Epidemiology, and End Results program and the Institute for Health Metrics and Evaluation Global Burden of Disease database.


Bleyer A, et al. Cancer. 2019 Sep 25. doi: 10.1002/cncr.32498.


Prostate cancer has traditionally been considered a disease of men aged > 40 years. However, identification of this disease in men aged < 40 years and the evaluation of outcomes in such men is not well-described. Bleyer et al. describe the results of an important study on such epidemiology. Of concern is the finding that incidence of prostate cancer is rising in those ages 15-40 and that 5-year survival is worse for these patients compared to those aged > 40 years. This study supports increased consideration of prostate cancer in patients ages 15-40 when evaluating patients with signs and/or symptoms concerning for prostate cancer. —Mark A. Klein, MD