Over 3.6 million men in the United States harbor a diagnosis of prostate cancer (PCa). Understanding causes of death in contemporary survivors is essential for proper survivorship management. Thus, we sought to provide in-depth analyses of the causes of death during PCa survivorship.
Population-based cohort study from the United States (2000-2016) of 752,092 men with PCa was conducted, including 200,302 who died (27%), using the Surveillance, Epidemiology, and End Results database. Cause of death by time following PCa diagnosis stratified by patient demographics and tumor stage. Using general-population data, we calculated standardized mortality ratios (SMRs) as the ratio of observed to expected cause of death.
Among men with local/regional disease, most deaths occurred between 5 and 10 years (38%) following diagnosis. A total of 29,048 (17%) of these men died from PCa while more than 4-fold that died from other causes (n=143,683, 83%; Figure). SMRs for death from non-cancer deaths (0.77, 95%CI 0.77-0.78) suggest these men were less likely than the general population to die from most other causes. The most common non-cancer cause of death was cardiac-related (23%, SMR 0.76, 95% CI 0.75-0.77). Among men with distant PCa, 90% of deaths occurred within 5 years of diagnosis. While death due to PCa comprised the majority of deaths (74%), SMRs suggest these men were at a heightened risk of death from most other non-cancer causes (1.50, 95% CI 1.46-1.54). Risks of cardiac-related deaths (SMR 1.48, 95%CI 1.41-1.54) and suicide (SMR 2.32, 95% CI 1.78-2.96) were elevated. Causes of death varied substantially by patient demographics.
Causes of death during PCa survivorship vary by patient and tumor characteristics and non-PCa causes were 4-fold more frequent among men with local/regional disease. For men with distant disease, the risk of death for most non-PCa causes including cardiac and suicide was greater than that of the general population. These data provide valuable information regarding healthcare prioritization during PCa survivorship.
CAUSE OF DEATH DURING PROSTATE CANCER SURVIVORSHIP: A CONTEMPORARY US POPULATION-BASED ANALYSIS
Prostate Cancer > Other
Presented By: Adam B. Weiner
Authors: Adam B. Weiner
Eric V. Li
Anuj S. Desai
David J. Press
Edward M. Schaeffer