The incidence of late-stage prostate cancer for men living in a cluster of Northeastern Pennsylvania counties — including Luzerne and Schuylkill — is among the highest in Pennsylvania.
Out of all 67 Pennsylvania counties, Schuylkill ranks fifth, with 29.7 cases for every 100,000 males, while Luzerne ranks 10th with 28.9 cases.
The cluster also includes Berks, Bradford, Columbia, Montour and Sullivan counties, according to data from the National Cancer Institute, which is part of the National Institutes of Health.
In each of those counties, an annual average of at least 28 cases of the cancer has been reported for every 100,000 male residents between 2017 and 2021, according to the most recent data available from 2017 through 2021.
The state average is 25.3 cases, and the national average is 24.7 cases per 100,000 males.
In late-stage — or stage IV — prostate cancer, the cancer has metastasized, or spread beyond the prostate gland to other parts of the body and is generally considered terminal, with a significantly lower survival rate than in early-stage prostate cancer.
The incidence rate in Sullivan County far exceeds that of any other county in Pennsylvania, with an average of 61.7 cases per 100,000 males.
Some other counties adjacent to the NEPA cluster, including Lackawanna, Carbon and Wyoming, rank among the lowest in the state — 54th, 55th and 57th, respectively — for late-stage prostate cancer cases, with averages of 19.2 cases per 100,000 males in Lackawanna and Carbon, and 19 cases in Wyoming.
A closer look at the data
But, Karen Ryczak, a registered nurse and Vice President-Programs and Surveillance at the Northeast Regional Cancer Institute in Scranton, cautioned that that the incidence numbers reported can be misleading.
“For example, with Sullivan County, if you look at those data, … we’re looking at (an average of) four cases per year. … I tell people not to put a lot of weight when your numbers are that small,” Ryczak said. “That’s five years worth of data. It could be six cases in one year, none in another. So, the variability is there when we’re looking at small numbers.”
“Those variations can be due to chance, they can be due to things like lifestyle in a certain area, the medical care that might be available in that area, even the reporting practices — how these cancer cases get reported to the state. So, one of the things I also tell people is to look at the confidence interval. The closer the confidence interval when you’re looking at data, the more precise that data are going to be,” Ryczak said.
The data for Allegheny County is much more reliable, with a confidence interval ranging between 27.8 and 31.2 cases per 100,000 males — a variance of 3.4 cases per 100,000 males — and an average of 249 reported cases per year, Ryczak said.
Schuylkill, Luzerne and Berks counties had higher average numbers of cases at 31, 64 and 79, respectively, and had lower confidence intervals ranging between 5.7 and 10 cases, making the data for them more reliable.
Shortage of urologists
Dr. Angelo Baccala, Deputy Physician in Chief, Innovation and Program Development, Institute for Surgical Excellence, and Chief of the Division of Urology at Lehigh Valley Health Network, said a shortage of urologists also can play a part in higher instances of prostate cancer being reported in some counties.
“The number of urologists is really an issue right now for us. There’s just not enough around to take care of the population, and so, people sometimes travel to come to us … in order to achieve their urologic care,” Baccala said.
Baccala also noted that higher rates of prostate cancer were reported “right after the (COVID-19) pandemic because patients just weren’t coming in to see their doctors,” Baccala said. “So things were kind of delayed a little bit. … But, right now, it’s sort of back to the baseline.”
Baccala also said changing recommendations from the American Urological Association on when men should be screened could have contributed to a higher incidence rate in some areas.
Top 10 counties reporting late-term prostate cancer
The incidence rate in each county is the number of cases reported per 100,000 males.
- Sullivan — 61.7
- Philadelphia — 31.8
- Columbia — 31.6
- Schuylkill — 29.7
- Montour — 29.7
- Erie — 29.7
- Allegheny — 29.5
- Bradford — 29.1
- Venango — 28.9
- Luzerne — 28.9
