Roundup: Prostate Cancer Cases Rising Again, Especially Those in Advanced Stages; and More News

Prostate Cancer Rates Increasing Again, Especially Advanced Stage Diagnoses, American Cancer Society Reports

New cases of prostate cancer are on the rise once again after years of decline, according to the latest Prostate Cancer Statistics, 2025, from the American Cancer Society (ACS), published in CA: A Cancer Journal for Clinicians.

From 2007 through 2014, prostate cancer cases in the United States fell by an average of 6.4 percent per year. However, between 2014 and 2021, this pattern reversed with incidence rates increasing by 3 percent annually. The sharpest increases were seen in advanced-stage diagnoses, climbing at nearly 5 percent per year.

While overall death rates from prostate cancer have been declining since the 1990s, progress has slowed considerably. Mortality once dropped by 3–4 percent annually, but has slowed to just 0.6 percent per year in the past decade.

ACS guidelines recommend that men discuss prostate cancer screening with their healthcare providers starting at age 50. For Black men and those with a family history of prostate cancer, the conversation should begin at age 45.

The ACS report underscores that while overall survival remains high when prostate cancer is detected early, rising rates of advanced disease and persistent disparities demand renewed attention to prevention, screening access, and equity in care.

Confusion Over Screening Recommendations

Screening for prostate cancer has been a subject of debate for more than a decade. In 2012, the U.S. Preventive Services Task Force (USPSTF)—an independent panel that advises on preventive health care—recommended against routine prostate-specific antigen (PSA) testing in healthy men.

The decision was driven by concerns about overtreatment, as detecting very slow-growing cancers can lead to unnecessary procedures. Treatments such as surgery and radiation may result in lasting side effects, including urinary incontinence and sexual dysfunction.

However, the evidence behind this recommendation has since been questioned. The task force’s stance relied heavily on a large clinical trial that suggested PSA testing had little impact on survival. Later analysis revealed flaws in that study’s design, while other research has shown that PSA screening can, in fact, reduce prostate cancer mortality when applied appropriately. This conflicting evidence has fueled ongoing debate among physicians, patients, and researchers.

In 2018, the USPSTF modified its guidelines, advising that men aged 55 to 69 should make an individual decision about PSA screening after discussing risks and benefits with their doctor. For men age 70 and older, the task force recommended against screening altogether.

Yet many experts point out that life expectancy has increased, and healthy men in their 70s may still benefit from early detection and treatment. These conflicting perspectives continue to cause uncertainty, leaving patients and providers to navigate complex choices in prostate cancer prevention.

Persistent Racial and Ethnic Disparities

The ACS report highlights striking differences in prostate cancer outcomes across racial and ethnic groups.

• Black men face double the mortality rate of White men, despite a 67 percent higher incidence.
• Native American men have a 12 percent higher risk of death compared to White men, even though they experience lower overall incidence.
• Asian American and Pacific Islander men have the lowest mortality, with 8.8 deaths per 100,000 men.

American Indian and Alaska Native men are also more likely to be diagnosed with distant-stage disease (12 percent versus 8 percent among White men).

“Our research highlighting the continued increases in prostate cancer incidence and persistent racial disparities underscores the need for redoubled efforts to understand the etiology of prostate cancer and optimize early detection,” said Tyler Kratzer, MPH, ACS associate scientist and lead author of the study.

The Scope of the Problem

Prostate cancer remains the most frequently diagnosed cancer among American men, accounting for about 30 percent of all new male cancer cases in 2025. It is also the second leading cause of cancer death in men, behind lung cancer.

For 2025, the ACS estimates:

• 313,780 new prostate cancer cases
• 35,770 deaths

Researchers also note a concerning trend: distant-stage disease, which has a much lower survival rate, is increasing in men across all ages. Among men under 55, rates rose nearly 3 percent annually, while in those 55 and older, the increase reached 6 percent per year.

Survival outcomes depend heavily on stage at diagnosis. The five-year relative survival rate for distant-stage disease is only 38 percent, compared to nearly 100 percent when detected early.

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Two Out of Three U.S. Women of Reproductive Age Face Preventable Risks for Birth Defects

Most U.S. women of reproductive age (12–49 years) carry at least one preventable, or modifiable, risk factor linked to birth defects, according to a new study from the U.S. Centers for Disease Control and Prevention (CDC) published in the American Journal of Preventive Medicine.

These conditions—such as congenital heart defects, orofacial clefts (like cleft lip or cleft palate), and neural tube defects (problems with brain or spinal cord development)—are among the most common birth defects in the nation.

The research, based on more than a decade of data from the National Health and Nutrition Examination Survey (NHANES), shows both progress and setbacks in women’s pre-pregnancy health. Understanding these patterns is key to improving outcomes for future mothers and babies.

What Are Modifiable Risk Factors?

Risk factors are conditions or exposures that increase the chance of a health problem. Modifiable risk factors are those that can be changed—through behavior, diet, or medical care. In this study, researchers focused on six major modifiable risks tied to birth defects:

• Food insecurity: Limited or uncertain access to enough nutritious food.
• Low folate levels: Folate is a B vitamin crucial for early fetal development; low levels raise the risk of neural tube defects.
• Vitamin B12 deficiency: Another essential nutrient that supports nerve and blood health.
• Obesity: Having a body mass index (BMI) of 30 or higher.
• Diabetes and prediabetes: Conditions where blood sugar levels are elevated.
• Exposure to tobacco smoke: Measured by levels of cotinine, a marker of nicotine in the body.

Key Findings from 2007–2020

The study analyzed information from 5,374 nonpregnant, nonlactating women of reproductive age in the U.S. Here’s what researchers found:

• Widespread risk: About 66 percent of women had at least one modifiable risk factor.
• Multiple risks: More than 10 percent had three or more risk factors at the same time.
• Obesity on the rise: Obesity increased from 29 percent in 2007–2010 to nearly 38 percent in 2015–2020.
• Diabetes growing too: Diagnosed and undiagnosed diabetes nearly doubled, from 3.2 percent to 6.0 percent. Prediabetes rose to about 35 percent.
• Low folate remains common: One in five women had folate levels too low to best prevent neural tube defects.
• Supplement use lags: Only 12.6 percent of women took supplements containing the recommended 400 micrograms (mcg) of folic acid daily.
• Smoking exposure declined: Encouragingly, tobacco-related exposure dropped from 21 percent to 17 percent.
• Food insecurity worsened: The number of women reporting very low food security rose from 5 percent to over 7 percent.

Why Do These Risk Factors Matter?

Birth defects often develop in the first weeks of pregnancy—sometimes before a woman knows she is pregnant. This means that addressing health risks before conception is critical.

• Folate and vitamin B12 support cell growth and DNA formation. Without enough, babies face higher risks for defects of the brain and spine.
• Diabetes and obesity are linked not only to birth defects but also to pregnancy complications such as preeclampsia (dangerously high blood pressure) and stillbirth.
• Tobacco exposure affects blood flow and oxygen supply, harming both maternal and fetal health.
• Food insecurity limits access to essential nutrients, making it harder to maintain a healthy pregnancy.

Trends Over Time

The study shows both improvement and setbacks:

• Folate deficiency decreased modestly, suggesting that folic acid fortification of foods continues to help.
• At the same time, obesity and diabetes became more common, creating new challenges for maternal health.
• Smoking exposure declined, showing success of tobacco-control measures.
• Food insecurity worsened, likely reflecting broader economic and social pressures.

What Can Help?

The researchers stress the importance of preconception health care — 7medical guidance and support provided before pregnancy. This care may include:

• Encouraging a balanced diet rich in folate (found in leafy greens, beans, and fortified grains) and vitamin B12 (found in animal products and fortified foods).
• Recommending folic acid supplements of at least 400 mcg daily for women of reproductive age.
• Screening for and managing diabetes and obesity before pregnancy.
• Supporting smoking cessation.
• Expanding access to food assistance programs to reduce food insecurity.

Mediterranean Diet May Help Lower Genetic Risk for Alzheimer’s

Following a Mediterranean-style diet may reduce the risk of dementia, particularly in people with the highest genetic susceptibility to Alzheimer’s disease, according to a new study by investigators from Mass General Brigham, Harvard T.H. Chan School of Public Health, and the Broad Institute of MIT and Harvard .

This new study, published in Nature Medicine, adds substantially to a growing body of research indicating that diet plays an important role in brain health.

Understanding the Genetic Risk of Alzheimer’s

Alzheimer’s disease is the most common cause of dementia, a progressive decline in memory and thinking skills that primarily affects older adults. Genetics play a strong role, with heritability estimated at up to 80 percent. One of the most influential genetic risk factors is a variant of the apolipoprotein E (APOE) gene, known as APOE4.

• People with one copy of APOE4 have a three- to four-fold higher risk of developing Alzheimer’s.
• Those with two copies (called APOE4 homozygous) face a twelve-fold higher risk compared to individuals without the variant.

Because these risks cannot be changed, researchers are looking closely at lifestyle factors—such as diet—that may help offset them.

The Role of the Mediterranean Diet

The Mediterranean diet emphasizes plant-based foods such as vegetables, fruits, legumes, nuts, and whole grains. It also prioritizes olive oil as the main source of fat, includes moderate consumption of fish and poultry, and limits red meat and sweets. This pattern of eating has long been associated with heart health, but it is now being linked to cognitive protection as well.

“One reason we wanted to study the Mediterranean diet is because it is the only dietary pattern that has been causally linked to cognitive benefits in a randomized trial,” said Yuxi Liu, Ph.D., the study’s first author and research fellow at Brigham and Women’s Hospital, in a news release.

How the Study Was Conducted

Researchers analyzed health and dietary data from two large, long-term studies:

• The Nurses’ Health Study, including 4,215 women followed from 1989 to 2023.
• The Health Professionals Follow-Up Study, including 1,490 men followed from 1993 to 2023.

Participants completed detailed food questionnaires, provided blood samples for metabolic analysis, and underwent genetic testing. A subset also received regular telephone-based cognitive assessments. Over the course of the studies, researchers tracked the development of dementia.

Key Findings

The results showed that individuals who adhered more closely to a Mediterranean-style diet had:

• A lower overall risk of dementia.
• Slower rates of cognitive decline over time.

Importantly, the protective effect was strongest among those at the highest genetic risk—people with two copies of the APOE4 gene. This suggests that diet may help counterbalance inherited susceptibility.

“These findings suggest that dietary strategies, specifically the Mediterranean diet, could help reduce the risk of cognitive decline and stave off dementia by broadly influencing key metabolic pathways,” Dr. Liu explained in a news release.

Limitations and Next Steps

The study was based primarily on well-educated participants of European ancestry, which limits how broadly the findings can be applied. Further research in more diverse populations is needed. In addition, while blood metabolites—the chemical byproducts of food processing—may help explain the diet’s protective effects, this area of science is still developing.

Most people do not know their APOE genetic status, and genetic testing is not part of routine dementia risk assessments. Researchers emphasize that more work is required before genetic and metabolic information can be fully integrated into clinical practice.

While genetics cannot be changed, this study reinforces that lifestyle choices matter. Adopting a Mediterranean-style diet may not only support heart health but also provide meaningful protection for the brain—even for those most at risk for Alzheimer’s, the study concludes.