Abstract C023: The future of prostate cancer incidence and prevalence in non-Hispanic White and Black men in the United States

Abstract Background: Incidence and prevalence of prostate cancer have decreased in recent decades. There are notable differences between non-Hispanic White (NHW), and non-Hispanic Black (NHB) men. We applied age-period-cohort forecasting to address the question: can excesses in incidence and prevalence among NHB men be expected to persist in the future? Methods: Prostate cancer incidence and individual-level survival data were obtained from SEER-12 registry data (1992-2021; ages 40-84). We apply age-period-cohort and JoinPoint modelling to estimate incidence and 95% confidence intervals (CI) by single year of age and period. The models are used to forecast incidence to year 2035 using both observed birth cohort and period trends as measured by JoinPoint and curvature. We modelled survival using JoinPoint for the relative hazard of all-cause death by age and year at diagnosis. These estimates are combined to forecast the prevalence rate of prostate cancer survivors, defined as living individuals who received a diagnosis of prostate cancer within the past 15 years. Results: The estimated age-incidence rate of prostate cancer was substantially higher for NHB than NHW men; longitudinally, NHW men born in 1959 have a maximum risk of 590/100,000 (age 69), while NHB men born in the same year have a maximum risk of 1000/100,000 (age 68). JoinPoint models fit to cohort rate-ratios estimate a risk decrease of 1.45% (95% CI: 1.37-1.54) per birth year for NHW men born in or after 1931 while the corresponding decrease for NHB men starting in 1940 was 0.75%/year (0.53-0.96). NHW men are forecasted to have stable or decreasing incidence for all age groups, from 2021 to 2035 (ages 40-54.: 44 to 35 per 100,000; 55-69: 450 to 342; 70-84: 540 to 473). Corresponding estimated decreases for NHB men are similar (116 to 90; 816 to 601; 757 to 600). Estimated overall survival for men diagnosed at age 62 in year 2006 was higher for NHW than NHB men: 93.5 vs 87.9% 5-year, 84.8 vs 74.5% 10-year, and 73.1 vs 59.5% 15-year. Relative to this baseline, recent estimated trends differ between groups: among NHW men, the EAPC of relative risk from year of diagnosis changed from -5.8%/year (95% CI: -8.0 – -3.5%) during 2006-2010 to -0.4%/year (-0.9 – 0.1%), while NHBs had an EAPC of -2.0% (-2.6% – -1.5%) 2002-2017 and 10.7% (2.1 – 20.1% (maybe affected by COVID mortality) 2007-2021. NHW men are forecasted to have stable or decreasing prevalence for all age groups, from 2021 to 2035 (ages 40-54.: 165 to 138 per 100,000; 55-69: 3153 to 2533; 70-84: 8186 to 6837). Prevalence is also estimated to decrease for NHB men, although NHB rates are much higher overall than for NHW men (472 to 388; 5909 to 4591; 11690 to 8275). Conclusion or Impact: In our forecast models, absolute rates remain high in the future. Decreases in prevalence correspond to decreases in incidence and differences between NHW and NHB populations are expected to persist. Our analysis may inform or compliment research on prostate cancer prevention and survivorship. Citation Format: Douglas A. Monroe, Philip S. Rosenberg, Rachael Stolzenberg-Solomon, Hormuzd Katki, Ana F. Best. The future of prostate cancer incidence and prevalence in non-Hispanic White and Black men in the United States [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr C023.