Trends in Metastatic Breast and Prostate Cancer — Lessons in Cancer Dynamics

• Published in: The New England journal of medicine Vol. 373; no. 18; pp. 1685 - 1687
• Main Authors: Welch, H. Gilbert, Gorski, David H, Albertsen, Peter C
• Format: Journal Article
• Language: English
• Published: United States Massachusetts Medical Society 29-10-2015
• Subjects: Adult; Age; Breast cancer; Breast Neoplasms - epidemiology; Breast Neoplasms - pathology; Early Detection of Cancer - trends; Early Detection of Cancer - utilization; Female; Humans; Incidence; Male; Mammography; Metastases; Metastasis; Middle Aged; Mortality; Neoplasm Metastasis - physiopathology; Prostate cancer; Prostate-Specific Antigen - blood; Prostatic Neoplasms - epidemiology; Prostatic Neoplasms - pathology; SEER Program; Trends; United States - epidemiology; United States; United States > US; Puget Sound
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMp1510443

Discordant trends in the incidence of metastatic breast and prostate cancer since the widespread implementation of early-detection efforts may reflect distinct disease dynamics or may result from the different screening strategies used.
Patients who present with metastatic cancer serve as powerful motivators for efforts to detect cancer early. Screening offers hope that cancer can be detected in an early, localized phase when it's more amenable to treatment. This hope is based on a paradigm attributed to William Stewart Halsted, which holds that cancer arises at a single location, grows there, and eventually migrates to local lymph nodes and then to more distant organs. If the Halstedian paradigm is correct, effective screening should allow cancers destined to metastasize to be identified at an earlier stage and reduce the incidence of cancers that first . . .