Owing to improved survival among US patients with prostate cancer (PC), patients tend to live long enough after a PC diagnosis for non-cancer-related comorbidities to be associated with their overall survival. Although studies have investigated causes of death among patients with localized PC, data are lacking regarding causes of death among patients with metastatic PC.
To assess causes of death among US patients with metastatic PC from 2000 to 2016.
This retrospective cohort study used data from the Surveillance, Epidemiology, and End Results Program database to analyze a sample of 26 168 US men who received a diagnosis of metastatic PC from January 1, 2000, to December 31, 2016. Data were analyzed from February 2 to July 28, 2020.
Diagnosis of metastatic PC.
Standardized mortality ratios (SMRs) for different causes of death were calculated by dividing the observed number of deaths from each cause of death by the expected number of deaths in the age-matched US male population for the same period, adjusting for age and race/ethnicity.
Of 26 168 patients with metastatic PC included in the analysis, 48.9% were aged 50 to 70 years (mean age at diagnosis, 70.83 years); 74.5% were White individuals, and 72.7% received a diagnosis of stage M1b metastatic PC. A total of 16 732 patients (63.9%) died during the follow-up period. The mean age at death was 74.13 years. Most deaths (59.0%) occurred within the latency period of 2 years after diagnosis of metastatic PC, whereas 31.6% occurred 2 to 5 years after diagnosis and 9.4% occurred more than 5 years after diagnosis. Of the total deaths, 13 011 (77.8%) were from PC, 924 (5.5%) were from other cancers, and 2797 (16.7%) were from noncancer causes. During all latency periods, the most common noncancer causes of death were cardiovascular diseases (SMR, 1.34; 95% CI, 1.26-1.42), chronic obstructive pulmonary disease (SMR, 1.19; 95% CI, 1.03-1.36), and cerebrovascular diseases (SMR, 1.31; 95% CI, 1.13-1.50).
In this cohort study, deaths from noncancer causes, including cardiovascular disease, constituted a substantial number of deaths among men with metastatic PC. Therapy and follow-up should be tailored to the needs of each patient with metastatic PC, and counseling regarding future health risks should be provided.
JAMA network open. 2021 Aug 02*** epublish ***
Ahmed O Elmehrath, Ahmed M Afifi, Muneer J Al-Husseini, Anas M Saad, Nathaniel Wilson, Kyrillus S Shohdy, Patrick Pilie, Mohamad Bassam Sonbol, Omar Alhalabi
Faculty of Medicine, Cairo University, Cairo, Egypt., University of Kentucky College of Medicine, Lexington., Department of Medicine, Ascension St John Hospital, Detroit, Michigan., Faculty of Medicine, Ain Shams University, Cairo, Egypt., Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston., Division of Hematology and Medical Oncology, Department of Medicine, Weill Cornell Medicine, New York, New York., Department of Genitourinary Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas., Mayo Clinic Cancer Center, Division of Hematology and Oncology, Mayo Clinic, Phoenix, Arizona.