Alarming Rise in Rates of Advanced Prostate Cancer in California

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class="main-submenu main-nav__search"> <div class="home-search__form"> <form action="/search" accept-charset="utf-8" method="get" class="search__form"> <label for="header-desktop-search" class="visually-hidden">search</label> <input type="text" name="search" id="header-desktop-search" size="32" class="home-search__form-input" value="" placeholder="Search people, places, ideas" /> <fieldset class="fieldset-reset"> <legend class="visually-hidden">Choose what type of search to perform</legend> <div class="search-filter"> <label> <input type="radio" name="filter" class="visually-hidden search-filter__radio" value="All" checked> <div class="search-filter__label"> <span class="search-filter__option"></span> <span>All UCSF</span> </div> </label> <label> <input type="radio" name="filter" class="visually-hidden search-filter__radio" value="News"> <div class="search-filter__label"> <span class="search-filter__option"></span> <span>UCSF News Center</span> </div> </label> </div> </fieldset> <input type="submit" id="edit-submit" name="op" value="Search" class="home-search__form-submit"> </form> </div> </div> </li> </ul> </nav> </div> </section> </header> <div class="help"> <div class="region-highlighted"> <div data-drupal-messages-fallback class="hidden"></div> </div> </div> <div class="region-content"> <div id="block-ucsf-content" class="block block-system block-system-main-block"> <main class="main "> <a id="main-content" tabindex="-1"></a> <div data-history-node-id="429401" class="article-twocol-banner twocolleftdark"> <div class="article-twocol-banner-image"> <figure> <picture class="field field-two-column-banner-image field--type-entity-reference field--label-hidden field__item"> <source srcset="/sites/default/files/styles/two_col_banner_full/public/2025-01/organoid-prostate-cells.jpg 1x, /sites/default/files/styles/two_col_banner_full_2x/public/2025-01/organoid-prostate-cells.jpg 2x" media="all and (min-width: 1280px)" type="image/jpeg" width="720" height="780"/> <source srcset="/sites/default/files/styles/two_col_banner_large/public/2025-01/organoid-prostate-cells.jpg 1x, /sites/default/files/styles/two_col_banner_large_2x/public/2025-01/organoid-prostate-cells.jpg 2x" media="all and (min-width: 1050px) and (max-width: 1280px)" type="image/jpeg" width="640" height="693"/> <source srcset="/sites/default/files/styles/two_col_banner_medium/public/2025-01/organoid-prostate-cells.jpg 1x, /sites/default/files/styles/two_col_banner_large_2x/public/2025-01/organoid-prostate-cells.jpg 2x" media="all and (min-width: 850px) and (max-width: 1049px)" type="image/jpeg" width="1050" height="1138"/> <source srcset="/sites/default/files/styles/two_col_banner_narrow/public/2025-01/organoid-prostate-cells.jpg 1x, /sites/default/files/styles/two_col_banner_large_2x/public/2025-01/organoid-prostate-cells.jpg 2x" media="all and (min-width: 769px) and (max-width: 849px)" type="image/jpeg" width="850" height="921"/> <source srcset="/sites/default/files/styles/two_col_banner_narrow/public/2025-01/organoid-prostate-cells.jpg 1x, /sites/default/files/styles/two_col_banner_large_2x/public/2025-01/organoid-prostate-cells.jpg 2x" media="all and (max-width: 768px)" type="image/jpeg" width="850" height="921"/> <source srcset="/sites/default/files/styles/two_col_banner_x_small/public/2025-01/organoid-prostate-cells.jpg 1x, /sites/default/files/styles/two_col_banner_x_small_2x/public/2025-01/organoid-prostate-cells.jpg 2x" media="all and (max-width: 599px)" type="image/jpeg" width="600" height="650"/> <img loading="eager" src="/sites/default/files/styles/two_col_banner_medium/public/2025-01/organoid-prostate-cells.jpg" width="1050" height="1138" alt="A microscopic image showing multicolored prostate cells from an organoid, a human-made construct made to resemble an organ." class="element-fade"/> </picture> <figcaption class="article-art-credit">Human prostate cells from an organoid, an artificial construct that resembles an organ. Image by National Cancer Institute, NIH</figcaption> </figure> </div> <header class="article-header article-twocol-header"> <ul class="article-header__byline"> <li class="article-header__primary-area" data-primary-area="pa-research">Research</li> <li class="article-header__date"> <div class="field field-date-and-time field--type-datetime field--label-hidden field__item"><time datetime="2025-02-04T00:21:51Z" class="datetime"> February 3, 2025 </time> </div> </li> </ul> <h1><span class="field field--name-title field--type-string field--label-hidden">Alarming Rise in Rates of Advanced Prostate Cancer in California</span> </h1> <h2 class="field field-sub-title field--type-text field--label-hidden article-header__subheading">Following a change in screening guidelines, the incidence went up across the state, even more than it has nationally.</h2> <p class="article-header__author"> By <a href="https://www.ucsf.edu/bio/elizabeth-fernandez">Elizabeth Fernandez</a></p> </header> </div> <div class="main-content article-feature-content narrow-page"> <ul class="article-meta-share"> <li><a rel="nofollow" href="https://www.facebook.com/share.php?u=https://www.ucsf.edu/news/2025/01/429401/alarming-rise-rates-advanced-prostate-cancer-california" target="_blank" title="Share on Facebook"><span class="fab fa-facebook-square"></span> <span class="indent-text">Share on Facebook</span></a></li> <li><a rel="nofollow" href="https://www.twitter.com/share?text=Alarming Rise in Rates of Advanced Prostate Cancer in California&url=https://www.ucsf.edu/news/2025/01/429401/alarming-rise-rates-advanced-prostate-cancer-california" target="_blank" title="Share on Twitter"><span class="fa-brands fa-square-x-twitter"></span> <span class="indent-text">Share on Twitter</span></a></li> <li><a rel="nofollow" href="https://www.reddit.com/submit?url=https://www.ucsf.edu/news/2025/01/429401/alarming-rise-rates-advanced-prostate-cancer-california&title=Alarming Rise in Rates of Advanced Prostate Cancer in California" target="_blank" title="Share on Reddit"><span class="fab fa-reddit-square"></span> <span class="indent-text">Share on Reddit</span></a></li> <li><a rel="nofollow" href="/cdn-cgi/l/email-protection#a39cd7cc9e85d0d6c1c9c6c0d79ee5d1ccce83f6e0f0e583edc6d4d09983e2cfc2d1cecacdc483f1cad0c683cacd83f1c2d7c6d083ccc583e2c7d5c2cdc0c6c783f3d1ccd0d7c2d7c683e0c2cdc0c6d183cacd83e0c2cfcac5ccd1cdcac285c1ccc7da9ee2cfc2d1cecacdc483f1cad0c683cacd83f1c2d7c6d083ccc583e2c7d5c2cdc0c6c783f3d1ccd0d7c2d7c683e0c2cdc0c6d183cacd83e0c2cfcac5ccd1cdcac28693e78693e28693e78693e2f1c2d7c6d083ccc583c2c7d5c2cdc0c6c783d3d1ccd0d7c2d7c683c0c2cdc0c6d183cacd83e0c2cfcac5ccd1cdcac283d1ccd0c683d0cac4cdcac5cac0c2cdd7cfda83cacd83d7cbc683c7c6c0c2c7c683d0cacdc0c683c7ccc0d7ccd1d083d0d7ccd3d3c6c783d1ccd6d7cacdc6cfda83d0c0d1c6c6cdcacdc483c2cfcf83cec6cd8d83e283f6e0f0e583d0d7d6c7da83d1c6cacdc5ccd1c0c6d083d7cbc683cdc6c6c783c5ccd183d0c0d1c6c6cdcacdc483d7cbc2d783c0c2cd83cac7c6cdd7cac5da83d3ccd7c6cdd7cac2cfcfda83c5c2d7c2cf83d7d6ceccd1d083d4cad7cbccd6d783d1c2cad0cacdc483c5c2cfd0c683c2cfc2d1ced083c2c1ccd6d783cccdc6d083d7cbc2d783d3ccd0c683cfcad7d7cfc683d7cbd1c6c2d78d8693e78693e28693e78693e2cbd7d7d3d0998c8cd4d4d48dd6c0d0c58dc6c7d68ccdc6d4d08c919391968c93928c97919a9793928cc2cfc2d1cecacdc48ed1cad0c68ed1c2d7c6d08ec2c7d5c2cdc0c6c78ed3d1ccd0d7c2d7c68ec0c2cdc0c6d18ec0c2cfcac5ccd1cdcac2" title="Email this article"><span class="fas fa-envelope-square"></span> <span class="indent-text">Email this article</span></a></li> <li><a rel="nofollow" onclick="window.print();return false;" href="https://www.ucsf.edu/news/2025/01/429401/alarming-rise-rates-advanced-prostate-cancer-california" title="Print this article"><span class="fas fa-print"></span> <span class="indent-text">Print this article</span></a></li> </ul> <div class="page_narrow"><p class="drop-cap">The incidence of advanced prostate cancer in California rose markedly in the decade since doctors stopped routinely screening all men for the disease, according to a new study by UC San Francisco.</p> <p>After declining for many years, the death rate from the disease also plateaued in most regions across the state.</p> <p>The findings reinforce the need for screening that can identify potentially fatal tumors without raising false alarms about ones that pose no threat to the patient.</p> <p>The study appears Jan. 27 in <em><a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2024.56825?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=012725">JAMA Network Open</a></em>.</p> <p>“This overall rising trend is alarming and has occurred across age groups, regions of California, races and ethnicities,” said lead author <a href="https://profiles.ucsf.edu/erin.vanblarigan">Erin L. Van Blarigan</a>, ScD, UCSF associate professor of Epidemiology & Biostatistics and Urology.</p> <p>“Our data point to how urgent this problem is,” said Van Blarigan, who is also with the <a href="https://cancer.ucsf.edu">UCSF Helen Diller Family Comprehensive Cancer Center</a>. “Figuring out the best way to screen for prostate cancer continues to be a challenge for researchers and doctors. Without screening, the number of men diagnosed with advanced prostate cancer – when treatments are less effective – increases fast.”</p> </div> <div class="paragraph-text-block paragraph-responsive-areas"> <div class="clearfix text-formatted field field-desktop-area field--type-text-long field--label-hidden field__item"><h2 class="visually-hidden">Advanced prostate cancer rates in different regions of California per 100,000 (2004 – 2021)</h2> <p class="visually-hidden">Note: these figures are adjusted for reporting delays</p> <p class="visually-hidden">Superior California rates: 2004: 6.36; 2005: 7.11; 2006: 7.4; 2007: 7.92; 2008: 8.37; 2009: 7.96; 2010: 6.78; 2011: 8.11; 2012: 9.39; 2013: 8.6; 2014: 9.14; 2015: 10.61; 2016: 9.55; 2017: 10.97; 2018: 13.76; 2019: 13.3; 2020: 14.68; 2021: 14.53.</p> <p class="visually-hidden">North Coast rates: 2004: 8.81; 2005: 12.04; 2006: 7.76; 2007: 10.27; 2008: 9.22; 2009: 8.19; 2010: 6.1; 2011: 8.56; 2012: 9.74; 2013: 9.28; 2014: 8.7; 2015: 8.6; 2016: 12.95; 2017: 11.46; 2018: 16.79; 2019: 11.54; 2020: 14.78; 2021: 18.42.</p> <p class="visually-hidden">San Francisco Bay rates: 2004: 7.84; 2005: 8; 2006: 8.28; 2007: 8.49; 2008: 8.24; 2009: 8.08; 2010: 7.69; 2011: 8.54; 2012: 8.11; 2013: 9.46; 2014: 8.21; 2015: 10.04; 2016: 10.47; 2017: 11.98; 2018: 11.01; 2019: 12; 2020: 11.84; 2021: 15.72.</p> <p class="visually-hidden">North San Joaquin Valley rates: 2004: 7.72; 2005: 6.62; 2006: 6.87; 2007: 7.21; 2008: 7.07; 2009: 7.02; 2010: 5.9; 2011: 7.72; 2012: 8.27; 2013: 7.69; 2014: 8.61; 2015: 10.11; 2016: 10.04; 2017: 10.9; 2018: 10.02; 2019: 10.72; 2020: 10.65; 2021: 15.24.</p> <p class="visually-hidden">Central Coast rates: 2004: 6.31; 2005: 6.54; 2006: 7.31; 2007: 6.39; 2008: 5.42; 2009: 5.87; 2010: 7.83; 2011: 6.89; 2012: 8.72; 2013: 5.89; 2014: 7.92; 2015: 9.14; 2016: 10.85; 2017: 11.68; 2018: 11.53; 2019: 10.79; 2020: 12.89; 2021: 15.42.</p> <p class="visually-hidden">South San Joaquin Valley rates: 2004: 6.8; 2005: 8.78; 2006: 9.01; 2007: 6.64; 2008: 6.52; 2009: 8.49; 2010: 6.19; 2011: 8.2; 2012: 6.8; 2013: 9.64; 2014: 7.48; 2015: 10.55; 2016: 8.24; 2017: 9.94; 2018: 9.13; 2019: 10.72; 2020: 9.37; 2021: 10.64.</p> <p class="visually-hidden">Inland Empire rates: 2004: 8.49; 2005: 9.53; 2006: 9.43; 2007: 7.2; 2008: 6.23; 2009: 7.59; 2010: 6.9; 2011: 6.53; 2012: 6.81; 2013: 7.32; 2014: 7.94; 2015: 8.84; 2016: 9.5; 2017: 10.36; 2018: 10.9; 2019: 11.43; 2020: 10.25; 2021: 12.67.</p> <p class="visually-hidden">Los Angeles County Rates: 2004: 7.73; 2005: 7.47; 2006: 6.77; 2007: 6.41; 2008: 6.59; 2009: 6.6; 2010: 6.85; 2011: 6.21; 2012: 6.75; 2013: 7.05; 2014: 7.31; 2015: 7.63; 2016: 9.21; 2017: 9; 2018: 9.38; 2019: 10.53; 2020: 9.9; 2021: 11.35.</p> <p class="visually-hidden">Orange County rates: 2004: 7.11; 2005: 5.35; 2006: 6.74; 2007: 5.21; 2008: 7.18; 2009: 5.77; 2010: 7.43; 2011: 5.49; 2012: 6.61; 2013: 6.46; 2014: 7.21; 2015: 7.25; 2016: 8.19; 2017: 9.01; 2018: 8.43; 2019: 10.46; 2020: 9.28; 2021: 11.85.</p> <p class="visually-hidden">San Diego, Imperial rates: 2004: 9.43; 2005: 7.23; 2006: 8.28; 2007: 8.94; 2008: 8.04; 2009: 7.8; 2010: 7.46; 2011: 7.63; 2012: 9.36; 2013: 9.39; 2014: 10.13; 2015: 10.11; 2016: 9.66; 2017: 13.63; 2018: 13.13; 2019: 15.45; 2020: 13.18; 2021: 15.57.</p> <script data-cfasync="false" src="/cdn-cgi/scripts/5c5dd728/cloudflare-static/email-decode.min.js"></script><script src="https://infograph.venngage.com/js/embed/v1/embed.js" data-vg-id="MOrQvumxe4w" data-title="DESKTOP - Prostate cancer rates in CA regions" data-w="900" data-h="600" data-multipage="true" data-f="false"></script></div> <div class="clearfix text-formatted field field-mobile-area field--type-text-long field--label-hidden field__item"><h2 class="visually-hidden">Advanced prostate cancer rates in different regions of California per 100,000 (2004 – 2021)</h2> <p class="visually-hidden">Note: these figures are adjusted for reporting delays</p> <p class="visually-hidden">Superior California rates: 2004: 6.36; 2005: 7.11; 2006: 7.4; 2007: 7.92; 2008: 8.37; 2009: 7.96; 2010: 6.78; 2011: 8.11; 2012: 9.39; 2013: 8.6; 2014: 9.14; 2015: 10.61; 2016: 9.55; 2017: 10.97; 2018: 13.76; 2019: 13.3; 2020: 14.68; 2021: 14.53.</p> <p class="visually-hidden">North Coast rates: 2004: 8.81; 2005: 12.04; 2006: 7.76; 2007: 10.27; 2008: 9.22; 2009: 8.19; 2010: 6.1; 2011: 8.56; 2012: 9.74; 2013: 9.28; 2014: 8.7; 2015: 8.6; 2016: 12.95; 2017: 11.46; 2018: 16.79; 2019: 11.54; 2020: 14.78; 2021: 18.42.</p> <p class="visually-hidden">San Francisco Bay rates: 2004: 7.84; 2005: 8; 2006: 8.28; 2007: 8.49; 2008: 8.24; 2009: 8.08; 2010: 7.69; 2011: 8.54; 2012: 8.11; 2013: 9.46; 2014: 8.21; 2015: 10.04; 2016: 10.47; 2017: 11.98; 2018: 11.01; 2019: 12; 2020: 11.84; 2021: 15.72.</p> <p class="visually-hidden">North San Joaquin Valley rates: 2004: 7.72; 2005: 6.62; 2006: 6.87; 2007: 7.21; 2008: 7.07; 2009: 7.02; 2010: 5.9; 2011: 7.72; 2012: 8.27; 2013: 7.69; 2014: 8.61; 2015: 10.11; 2016: 10.04; 2017: 10.9; 2018: 10.02; 2019: 10.72; 2020: 10.65; 2021: 15.24.</p> <p class="visually-hidden">Central Coast rates: 2004: 6.31; 2005: 6.54; 2006: 7.31; 2007: 6.39; 2008: 5.42; 2009: 5.87; 2010: 7.83; 2011: 6.89; 2012: 8.72; 2013: 5.89; 2014: 7.92; 2015: 9.14; 2016: 10.85; 2017: 11.68; 2018: 11.53; 2019: 10.79; 2020: 12.89; 2021: 15.42.</p> <p class="visually-hidden">South San Joaquin Valley rates: 2004: 6.8; 2005: 8.78; 2006: 9.01; 2007: 6.64; 2008: 6.52; 2009: 8.49; 2010: 6.19; 2011: 8.2; 2012: 6.8; 2013: 9.64; 2014: 7.48; 2015: 10.55; 2016: 8.24; 2017: 9.94; 2018: 9.13; 2019: 10.72; 2020: 9.37; 2021: 10.64.</p> <p class="visually-hidden">Inland Empire rates: 2004: 8.49; 2005: 9.53; 2006: 9.43; 2007: 7.2; 2008: 6.23; 2009: 7.59; 2010: 6.9; 2011: 6.53; 2012: 6.81; 2013: 7.32; 2014: 7.94; 2015: 8.84; 2016: 9.5; 2017: 10.36; 2018: 10.9; 2019: 11.43; 2020: 10.25; 2021: 12.67.</p> <p class="visually-hidden">Los Angeles County Rates: 2004: 7.73; 2005: 7.47; 2006: 6.77; 2007: 6.41; 2008: 6.59; 2009: 6.6; 2010: 6.85; 2011: 6.21; 2012: 6.75; 2013: 7.05; 2014: 7.31; 2015: 7.63; 2016: 9.21; 2017: 9; 2018: 9.38; 2019: 10.53; 2020: 9.9; 2021: 11.35.</p> <p class="visually-hidden">Orange County rates: 2004: 7.11; 2005: 5.35; 2006: 6.74; 2007: 5.21; 2008: 7.18; 2009: 5.77; 2010: 7.43; 2011: 5.49; 2012: 6.61; 2013: 6.46; 2014: 7.21; 2015: 7.25; 2016: 8.19; 2017: 9.01; 2018: 8.43; 2019: 10.46; 2020: 9.28; 2021: 11.85.</p> <p class="visually-hidden">San Diego, Imperial rates: 2004: 9.43; 2005: 7.23; 2006: 8.28; 2007: 8.94; 2008: 8.04; 2009: 7.8; 2010: 7.46; 2011: 7.63; 2012: 9.36; 2013: 9.39; 2014: 10.13; 2015: 10.11; 2016: 9.66; 2017: 13.63; 2018: 13.13; 2019: 15.45; 2020: 13.18; 2021: 15.57.</p> <script src="https://infograph.venngage.com/js/embed/v1/embed.js" data-vg-id="MOrQvumxe4w" data-title="DESKTOP - Prostate cancer rates in CA regions" data-w="900" data-h="600" data-multipage="true" data-f="false"></script><script src="https://infograph.venngage.com/js/embed/v1/embed.js" data-vg-id="u7WoZxjx8pM" data-title="MOBILE - Prostate cancer rates in CA regions" data-w="400" data-h="650" data-multipage="true" data-f="false"></script></div> </div> <div class="paragraph-text-block"> <h2><br> The challenge of screening for prostate cancer</h2> <p>Among men in the U.S., prostate cancer is the most common cancer and second-leading cause of cancer deaths. While some tumors are aggressive and can lead to death, the majority are low-grade and never spread.</p> <p>The most frequently used screening tool is PSA testing (prostate specific antigen), which does not differentiate between aggressive or non-aggressive tumors, leading many men to be diagnosed with cancers that would not hurt them in the long run.</p> <p>On the other hand, if screening isn’t done, timely diagnosis of more advanced cancers can be missed – those cancers might have been successfully treated if found early.</p> <p>After years of screening all men for prostate cancer, the U.S. Preventative Services Task Force stopped recommending it in 2012. They hoped to prevent unnecessary and potentially harmful interventions, like surgery, for men whose disease was not serious.</p> <p>In 2018, they began recommending that men between the ages of 55 and 69 discuss possible benefits and harms of screening with their doctors. But, as the authors note, this may not always be happening.</p> <h2>Prostate cancer mortality stops falling</h2> <p>UCSF researchers analyzed data involving nearly 388,000 men with prostate cancer in California between 2004 and 2021. Almost 28,000 (7.2%) had advanced disease, which has a five-year survival rate of just 37%. During the study timeframe, there were 58,754 deaths from prostate cancer.</p> <p>Investigators looked at 10 regions spanning the state to see if rates in certain areas were increasing   faster or slower.</p> <p>They found that serious disease, which had been stable or dropping until 2010, grew 6.7% a year from 2011 to 2021. By contrast, national rates grew by 4.5% a year from 2011 to 2019. The lowest annual increase was in the Southern San Joaquin Valley (2.3%), the highest was in the Central Coast (9.1%).</p> <p>Prostate cancer mortality dropped by 2.6% a year between 2004 and 2012; but after that, it plateaued in 7 out of 10 regions in the state. Mortality was highest in the Inland Empire followed by San Diego-Imperial and North Coast. It was lowest in the San Francisco Bay Area.</p> <p>“It’s important to continue monitoring prostate cancer trends both in California and nationally as we learn more about the impact of screening guidelines on different populations,” said senior author <a href="https://profiles.ucsf.edu/scarlett.gomez">Scarlett L. Gomez</a>, PhD, MPH, UCSF professor in the Department of Epidemiology & Biostatistics.</p> <p class="small-text"><strong>Additional authors:</strong> Meg A. McKinley, MPH; Samuel L. Washington III, MD, MAS; Matthew R. Cooperberg, MD, MPH; Stacey A. Kenfield, ScD; and Iona Cheng, PhD, all with UCSF.</p> <p class="small-text"><strong>Funding:</strong> California Department of Public Health; Centers for Disease Control and Prevention’s National Program of Cancer Registries (1NU58DP007156); the National Cancer Institute’s Surveillance, Epidemiology and End Results Program (HHSN2612018000321, HHSN2612018000151, HHSN2612018000091).</p> <p class="small-text"><strong>Disclosures:</strong> Please see the paper.</p> </div> <div class="tags-menu-region"> <h3 class="tags-menu__title">Topics</h3> <ul class="tags-menu"> <li class="tags-menu__item"><a href="/topics/cancer" hreflang="en">Cancer</a></li> <li class="tags-menu__item"><a href="/topics/prostate-cancer" hreflang="en">Prostate Cancer</a></li> <li class="tags-menu__item"><a href="/taxonomy/term/627" hreflang="en">Clinical Medicine</a></li> <li class="tags-menu__item"><a href="/topics/epidemiology" hreflang="en">Epidemiology</a></li> <li class="tags-menu__item"><a 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Alarming Rise in Rates of Advanced Prostate Cancer in California | UC San Francisco