We evaluated prostate cancer death in relation to age and PSA level immediately prior to prostate cancer diagnosis. Using the Veterans Affairs database, we identified 230,081 men aged 50-89 years diagnosed with prostate cancer and at least one prior PSA test between 1999 and 2009.
Prostate cancer-specific death over time was calculated for patients stratified by age group (e.g., 50-59 years, through 80-89 years) and PSA range at diagnosis (10 ranges) using Kaplan-Meier methods.
Risk of 10-year prostate cancer mortality across age and PSA was compared using log-rank tests with a Bonferroni adjustment for multiple testing.
10.5% of men diagnosed with prostate cancer died of cancer during the 10-year study period (mean follow-up = 3.7 years). Higher PSA values prior to diagnosis predict a higher risk of death in all age groups (p < 0.0001).
Within the same PSA range, older age groups are at increased risk for death from prostate cancer (p < 0.0001). For PSA of 7-10 ng/mL, cancer-specific death, 10 years after diagnosis, increased from 7% for age 50-59 years to 51% for age 80-89 years.
Men older than 70 years are more likely to die of prostate cancer at any PSA level than younger men, suggesting prostate cancer remains a significant problem among older men (even those aged 80+) and deserves additional study.
Front Oncol. 2016 Jun 28;6:157. doi: 10.3389/fonc.2016.00157. eCollection 2016.
MacKintosh FR1, Sprenkle PC2, Walter LC3, Rawson L1, Karnes RJ4, Morrell CH5, Kattan MW6, Nawaf CB7, Neville TB8.
1 VA Sierra Nevada Health Care System , Reno, NV , USA.
2 VA Connecticut Healthcare System, Yale School of Medicine , New Haven, CT , USA.
3 Division of Geriatrics, San Francisco VA Medical Center, University of California San Francisco , San Francisco, CA , USA.
4 Mayo Clinic , Rochester, MN , USA.
5 Loyola University Maryland , Baltimore, MD , USA.
6 Department of Quantitative Health Sciences, Cleveland Clinic , Cleveland, OH , USA.
7 Department of Urology, Yale School of Medicine , New Haven, CT , USA.
8 Soar BioDynamics, Inc. , Incline Village, NV , USA.
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