Cancer By County
Prostate Cancer3-5

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Background and Risk Factors

The prostate gland is located at the base of the penis, surrounds the urethra, and produces seminal fluid. The causes of prostate cancer are mostly unknown. Family history of prostate cancer in a first-degree relative (father, brother) appears to double the risk of prostate cancer. A history of some benign prostatic diseases such as prostatitis and some types of hyperplasias also may increase the risk. Male sex hormones such as testosterone may be related to prostate cancer. Various epidemiologic studies suggest that a diet high in animal fat leads to an increased risk of prostate cancer, perhaps through influencing hormone levels.

A sexually-transmitted agent is suspected of causing some cases of prostate cancer because sexual activity and sexually-transmitted diseases are more frequent among men with prostate cancer than men without prostate cancer. Certain occupational exposures also are suspected of causing prostate cancer: work with cadmium, farming, rubber manufacturing, and work in iron and steel foundries.

Prevention and Control

It is difficult to prevent prostate cancer because the causes are not well understood. The American Cancer Society recommends that every man 50 or older have a prostate- specific antigen (PSA) blood test and digital rectal examination as part of his annual physical checkup. (See Appendix I. )

Incidence and Mortality in the U.S.

Prostate cancer is the most common cancer among men; 184,500 new cases are estimated for 1998 in the U.S. Prostate cancer incidence rates have increased greatly since the late 1940s due partly to increased diagnosis in the asymptomatic or early stage. The incidence of prostate cancer is much higher in black men than white men and increases with age. Over 80 percent of all prostate cancers are diagnosed in men over age 65. The five-year survival rate is 89 percent; if diagnosed in the early stages, the five-year survival rate is 100 percent. With an estimated 39,200 deaths in 1998 in the U.S., prostate cancer is the second leading cause of cancer death among men. Prostate cancer mortality rates have also increased over the years. Black men have more than twice the prostate mortality rate as white men.

Incidence in New Jersey - 1986-1996

Tables 44 through 46 contain the incidence data by county for prostate cancer for the years 1986 through 1996. Figure 15 shows statewide trends; black males had higher rates than white males and the difference in rates appears to have increased since 1992. Black males had higher rates than white males in each county (see Table 44). The rates increased greatly between 1986 and 1992 for white males and between 1986 and 1993 for black males. After that the rates declined (see Figure 15). This time trend is probably due to the widespread introduction during these years of screening methods which detect prostate cancer earlier.

Conclusion

Continued research on the causes of prostate cancer is needed since the causes are not well understood. The recommendations regarding screening should be followed in order to detect it early.

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Table 44.
Prostate Cancer Incidence
By County, White Males, New Jersey - 1986-19961

COUNTY 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996
(Prelim.)

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

Atlantic

60

57.6

65

61.2

79

74.6

94

87.5

107

100.0

143

128.2

210

187.8

216

197.4

162

145.7

183

166.4

140

125.0

Bergen

347

76.3

430

94.6

425

92.2

432

92.5

538

113.4

754

156.2

941

193.0

777

159.1

718

147.6

691

142.2

667

138.3

Burlington

96

70.1

118

82.3

132

90.8

152

100.4

169

106.3

207

131.9

306

191.2

290

180.8

237

146.5

222

134.8

172

104.0

Camden

145

75.1

120

59.6

177

87.2

154

77.9

178

86.8

243

113.9

324

151.1

254

121.6

218

104.8

225

107.8

222

109.0

Cape May

65

97.5

68

98.4

74

106.9

93

127.4

96

132.5

132

180.7

148

195.1

144

197.6

124

169.1

133

178.7

115

152.9

Cumberland

35

56.4

46

74.3

48

75.2

45

70.5

57

86.9

84

127.6

95

148.1

105

164.9

69

109.7

59

93.0

85

136.0

Essex

204

71.3

249

87.4

254

90.5

253

91.5

308

114.3

420

155.7

560

210.8

443

168.7

418

163.5

344

135.7

364

149.5

Gloucester

57

75.1

60

78.1

57

70.9

48

56.8

76

84.3

95

101.2

133

144.2

127

134.1

119

124.7

111

112.7

81

83.8

Hudson

177

72.9

179

74.8

184

77.9

161

68.7

186

79.8

245

102.9

273

115.8

269

113.6

257

108.9

247

105.6

245

104.9

Hunterdon

32

81.4

28

70.3

29

72.6

42

99.7

38

86.2

41

92.9

60

130.1

77

160.5

54

112.3

39

78.9

46

92.1

Mercer

134

101.7

140

105.1

142

102.9

148

106.3

193

137.7

213

149.4

266

186.2

247

175.4

223

154.8

220

156.8

207

145.1

Middlesex

227

87.0

207

77.9

230

84.3

208

74.2

295

103.3

400

134.5

503

164.9

451

146.2

374

122.0

419

135.7

365

117.9

Monmouth

199

81.9

169

68.6

208

83.6

211

83.9

241

95.7

360

139.0

472

179.2

467

175.9

368

138.7

341

127.8

352

131.5

Morris

130

80.5

147

87.5

139

81.1

167

97.6

194

110.0

275

154.1

375

206.5

374

202.5

286

152.3

302

158.4

303

156.0

Ocean

279

81.0

290

80.4

293

80.4

300

78.0

350

92.1

560

142.8

774

194.5

655

168.9

568

148.0

494

128.5

330

88.0

Passaic

159

76.1

192

92.6

187

90.7

198

96.8

217

106.6

304

145.6

365

176.9

292

141.0

288

139.0

276

135.2

275

137.1

Salem

23

76.5

21

67.7

22

67.5

27

81.3

33

101.8

56

166.4

36

109.7

54

154.5

49

151.6

35

104.6

27

81.0

Somerset

57

62.3

64

67.5

73

76.0

86

87.0

88

87.4

121

114.3

190

172.2

140

124.6

137

120.7

142

121.8

154

130.4

Sussex

26

58.5

46

102.6

42

92.9

38

82.6

56

121.3

58

120.0

83

171.5

90

179.3

68

134.4

71

138.7

71

135.2

Union

214

84.4

205

80.7

230

90.5

261

102.6

296

117.2

424

162.6

558

216.0

374

146.5

293

117.3

301

119.9

335

136.2

Warren

46

106.4

38

86.0

55

126.3

40

88.7

42

91.5

61

131.3

102

209.9

90

186.6

61

127.2

92

187.0

64

125.4

STATE

2713

78.3

2882

82.0

3082

86.7

3162

88.0

3770

103.6

5221

140.7

6777

181.3

5939

158.8

5095

136.6

4962

132.7

4624

124.1


1Incidence rates - per 100,000 males, age-adjusted to the 1970 U.S. standard population. Cases of unknown county are included in the State numbers and rates. Source: New Jersey State Cancer Registry.

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Table 45.
Prostate Cancer Incidence
By County1, Black Males, New Jersey - 1986-19961

COUNTY 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996
(Prelim.)

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

Atlantic

20

128.1

19

122.6

25

162.1

21

131.5

9

59.4

17

104.1

38

220.0

41

230.7

27

148.6

54

285.2

47

252.5

Bergen

19

148.3

19

141.0

18

130.1

17

118.0

24

171.0

27

188.5

29

184.6

33

210.0

30

179.0

43

243.9

39

210.9

Burlington

14

107.5

16

124.8

24

189.8

19

134.7

29

176.2

40

267.4

46

313.9

49

265.7

59

344.6

54

271.1

43

188.4

Camden

28

129.1

23

100.8

37

158.6

25

101.9

27

110.2

46

179.7

66

248.3

59

213.7

52

184.8

66

220.6

40

127.6

Cumberland

10

170.7

---

---

6

91.9

7

115.7

9

140.5

11

186.6

5

76.4

21

306.3

10

151.3

11

144.0

13

174.2

Essex

117

138.1

109

120.3

146

162.7

133

141.3

169

185.8

182

196.2

225

237.0

233

234.5

218

221.3

246

238.4

228

216.7

Gloucester

7

91.0

14

181.8

7

78.6

5

64.2

12

140.7

10

106.0

22

229.9

25

254.3

19

196.4

15

137.7

15

139.5

Hudson

21

112.9

19

109.6

21

115.8

21

108.2

27

142.6

37

191.2

39

194.3

44

230.6

37

182.1

43

192.8

52

226.5

Mercer

24

130.4

22

121.8

22

113.6

21

102.6

43

220.1

36

174.5

56

258.5

69

315.9

61

269.2

73

303.7

66

264.9

Middlesex

10

95.2

15

155.3

16

158.8

20

156.9

13

104.5

14

106.0

37

281.5

38

255.3

35

246.5

24

142.2

20

124.2

Monmouth

9

55.7

21

121.9

18

108.9

15

87.4

20

118.7

28

151.8

37

186.0

43

212.4

31

149.2

49

221.6

37

162.5

Morris

---

---

---

---

7

212.4

---

---

---

---

7

191.7

8

214.4

15

389.2

15

446.5

8

202.3

8

168.5

Ocean

---

---

---

---

--

---

8

257.6

5

193.5

7

220.8

11

287.3

9

251.5

10

251.3

---

---

---

---

Passaic

16

91.8

17

152.0

22

149.9

11

65.6

19

110.3

21

126.9

25

137.5

29

166.1

34

182.6

29

159.3

36

176.6

Salem

7

165.3

---

---

7

163.9

7

160.7

5

112.5

7

149.1

9

189.6

13

249.5

8

156.0

9

177.3

14

248.5

Somerset

---

---

---

---

---

---

---

---

---

---

7

181.2

11

326.0

10

191.6

11

227.4

8

154.1

7

128.5

Union

27

117.9

31

123.1

37

140.6

44

163.0

39

145.6

50

176.2

76

258.7

82

278.0

73

236.9

86

252.0

72

209.6

STATE

338

121.7

346

121.3

420

143.3

386

126.4

463

152.0

554

175.7

745

228.1

828

244.3

741

213.9

830

224.9

749

196.8


1Incidence rates - per 100,000 males, age-adjusted to the 1970 U.S. standard population. Cases of unknown county are included in the State numbers and rates. Counties with six or more years of fewer than five cases each year were removed from the table - Cape May, Hunterdon, Sussex, and Warren counties. The dashes indicate fewer than five cases. Source: New Jersey State Cancer Registry.

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Table 46.
Prostate Cancer Incidence
By County And Race, Males, New Jersey - 1986-1996 Combined1

COUNTY

WHITE

BLACK

Number

Rate2

Number

Rate2

Atlantic

1459

121.6

318

171.5

Bergen

6720

127.1

298

176.7

Burlington

2101

121.8

393

222.6

Camden

2260

98.9

469

162.2

Cape May

1192

148.3

54

207.7

Cumberland

728

103.2

106

148.3

Essex

3817

128.2

2006

190.9

Gloucester

964

97.1

151

149.3

Hudson

2423

92.5

361

166.4

Hunterdon

486

98.1

5

172.4

Mercer

2133

137.9

493

211.5

Middlesex

3679

113.4

242

167.3

Monmouth

3388

118.4

308

145.9

Morris

2692

135.4

78

201.5

Ocean

4893

116.6

60

161.7

Passaic

2753

120.5

259

140.1

Salem

383

105.0

90

172.3

Somerset

1252

107.0

65

143.2

Sussex

649

121.8

---

---

Union

3491

123.7

617

193.9

Warren

691

132.9

9

259.7

STATE

48227

118.9

6400

179.3


1Incidence rates - per 100,000 males, age-adjusted to the 1970 U.S. standard population. Cases of unknown county are included in the State numbers and rates. The dashes indicate fewer than five cases. Source: New Jersey State Cancer Registry.
2Annual average rate.

Figure 15.

Figure 15

*1996 data are preliminary. Source: New Jersey State Cancer Registry.