Source: Prostate Cancer: A Review (2025), published in JAMA by Raychaudhuri, Lin & Montgomery JAMA Network+1
This recent comprehensive review offers a clear snapshot of what is currently known about prostate cancer — from how common it is to how it is best managed.
What the review tells us about prostate cancer
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Prostate cancer is the most frequent non-skin cancer among men in the United States, with nearly 299,010 new cases and around 35,250 deaths estimated in 2024. Worldwide, prostate cancer remains one of the most common cancers in men.
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The vast majority of cases (more than 99 per cent) are adenocarcinomas. The median age at diagnosis is 67 years.
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Genetic factors account for over half of the risk. Age and ethnicity also play a major role. For example, men of Black heritage have significantly higher incidence rates compared with White men.
How disease is generally detected and what outcomes look like
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At diagnosis, about three-quarters of men have cancer confined to the prostate (localised disease). For these men, five-year survival rates are close to 100 per cent.
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For many men with low-risk or favourable intermediate-risk disease, active surveillance — monitoring with PSA tests, imaging or biopsies — can be a safe option. Treatment such as surgery or radiotherapy is reserved for those whose cancer shows signs of progression.
When prostate cancer has spread or is higher risk
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A minority of men (about 10 per cent) are diagnosed when the cancer has already spread beyond the prostate (“metastatic disease”). In these cases, five-year survival falls significantly (reportedly around 37 per cent).
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For metastatic disease, standard care often starts with hormone therapy (medical castration). In recent years, adding drugs that block androgen-receptor signalling has improved survival compared with hormone therapy alone. For some men with more aggressive disease, chemotherapy remains an important component.
Why this matters now
This review highlights that prostate cancer is not one single disease, but a spectrum, from slow-growing, low-risk tumours that may never cause harm to aggressive, metastatic forms requiring intensive treatment. Because of this, a “one-size-fits-all” approach does not work.
Due to better understanding of risk factors, improved screening, and personalised decision-making, many men with prostate cancer can avoid over-treatment while maintaining excellent long-term outcomes. Meanwhile, for men with higher-risk or advanced disease, newer therapies continue to improve prognosis and survival.
