OBJECTIVE: To detail the distribution of causes of death for localised prostate cancer (PCa).
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PATIENTS AND METHODS: PCBase Sweden links the Swedish National Prostate Cancer Register (NPCR) with other nation-wide population-based healthcare registers. We selected all 57,187 men diagnosed with localised PCa between 1997-2009 and their 114,374 age- and county-matched PCa-free control men. Mortality was calculated using competing risk regression analyses, taking into account PCa risk category, age, and Charlson comorbidity index (CCI).
RESULTS: In men with low risk PCa, all-cause mortality was lower compared to corresponding PCa-free men: 10-year all-cause mortality was 18% for men diagnosed at age 70 with CCI=0 and 21% among corresponding controls. 31% of these cases died of CVD compared to 37% of their controls. For men with low-risk PCa, 10-year PCa-mortality was 0.4%, 1%, and 3% when diagnosed at age 50, 60, and 70, respectively. PCa was the third most common cause of death (18%), after CVD (31%) and other cancers (30%). In contrast, PCa was the most common cause of death in men with intermediate and high-risk localised PCa.
CONCLUSIONS: Men with low-risk PCa had lower all-cause mortality than PCa-free men due to lower cardiovascular mortality, driven by early detection selection. However, for men with intermediate or high-risk disease, PCa death was substantial, irrespective of CCI, and this was even more pronounced for those diagnosed at age 50 or 60.
Van Hemelrijck M, Folkvaljon Y, Adolfsson J, Akre O, Holmberg L, Garmo H, Stattin P. Are you the author?
King's College London, School of Medicine, Division of Cancer Studies, Cancer Epidemiology Unit, London, UK.
Reference: BJU Int. 2015 Jan 21. Epub ahead of print.