Prostate cancer is the second most common cancer in men worldwide, with an estimated 900,000 cases and 258,000 deaths in 2008 . In the United States there will be an estimated 233,000 cases and 29,500 deaths in 2014 . The clinical behavior of prostate cancer ranges from a microscopic, well-differentiated tumor that may never be clinically significant to an aggressive, high grade cancer that ultimately causes metastases, morbidity, and death.
The frequency of a diagnosis of prostate cancer has increased, due largely to the widespread use of serum prostate specific antigen (PSA) screening. Following the introduction of PSA testing, the incidence or prostate cancer peaked in 1992, declined between 1992 and 1995, and has risen since then at a rate of about 1 percent per year. The reasons for this increasing incidence are not known; both genetic and environmental factors have been implicated. The incidence is higher in blacks than in whites in the United States (figure 1). (See "Risk factors for prostate cancer" and "Screening for prostate cancer".)
An overview of the clinical presentation and initial diagnosis of men with prostate cancer is presented here. The staging system used for prostate cancer, the initial staging evaluation, and management approaches based upon risk are presented separately.
●(See "Initial staging and evaluation of men with newly diagnosed prostate cancer", section on 'Introduction'.)
●(See "Prostate cancer: Risk stratification and choice of initial treatment".)