Casey said: "The fact is that despite the clear reduction in the age-adjusted prostate cancer-specific mortality rate since the early 1990s, the actual number of men dying of prostate cancer has remained, over the same 20-year period, within a remarkably stable range from about 28,000 to 35,000 since the introduction of the PSA test."
There are several reasons why this statement is not totally accurate.
First is the issue of the life expectancy difference between 1990 and now (I only have life expectancy data through 2006)
Life expectancy, all races males, US, 1990:
At birth 71.8 years
At 65: 15.1 years
Life expectancy,all races males,US, 2006:
At birth 75.1 years
At 65: 17.0 years
As you can see men are living longer now and are more susceptible to get and die of PCa at an older age. In spite of that less men are dying of PCa now.
Another important consideration is that here in the U.S. it is commonly claimed that PSA is in widespread use. The "real" evidence suggests that in spite of the expressed "widespread" use of PSA testing only 41% of men age 50 or above admits having a PSA within the last year. Men age 50 to 64 had a worse score. Only 33.6% admitted to have a test within the last year. In men 65 and above the figure is 51.3%. This alone is an indication that the 40% reduction in the PCa mortality rate is limited and a wider use of PSA testing could further improve results.
Source: Swan J, Breen N, Coates RJ, Rimer BK, Lee NC. Progress in cancer screening
practices in the United States: results from the 2000 National Health Interview Survey.
Cancer. 2003 Mar 15;97(6):1528-40. PMID: 12627518
Last but not least, these are the actual PCa death figures:
Surviving prostate cancer since 1992 at age 58. RP; Orchiectomy; GS (4 + 2); bilateral seminal vesicle invasion; tumor attached to rectal wall; Stage T4; Last PSA September, 2010: <0.1 ng/ml
Laughter is still the best medicine!