More than half of deaths from prostate cancer in the United States occur among men initially diagnosed with low-grade disease, according to the findings of a large, population-based study presented at the Society of Urologic Oncology 22nd annual meeting.
Men diagnosed with prostate cancer after age 70 years are more likely to die from it compared with men diagnosed at a younger age.
Using data from the US Surveillance, Epidemiology, and End Results (SEER) program, Roderick Clark, MSc, of the University Health Network in Toronto, Ontario, Canada, and Steven Narod, MD, of the Familial Breast Cancer Research Unit at Women’s College Hospital, also in Toronto, analyzed long-term prostate cancer mortality rates in a population-based study that included 116,796 men diagnosed with the cancer during 1992-1997. These men were followed until 2017.
Of the 116,796 men, 21,896 died from prostate cancer. Most of these deaths (55.6%) occurred among men initially diagnosed with low-grade disease, with most deaths occurring more than 5 years after diagnosis, the investigators reported. Among men initially diagnosed with high-grade disease, most prostate cancer deaths (54.3%) occurred within the first 5 years of diagnosis.
Overall, the annual prostate cancer-specific mortality (PCSM) rate was 1.5%, but the rate increased with age at diagnosis, from 0.9% among men younger than 60 years to 1.2% and 2.1% for those 60-70 and older than 70 years, respectively.
Among men older than 60 years with low-grade prostate cancer, annual disease-specific mortality rates increase continuously with time from diagnosis, according to the investigators.
The overall 10- and 20-year prostate cancer-specific survival rates were 84.6% and 74.5%, respectively. The proportion of prostate cancer deaths during years 1-10 and 10-20 after diagnosis were 69.3% and 25.6%, respectively. These figures varied by age. Among men younger than 60 years, the 10- and 20-year prostate cancer-specific survival rates were 90.2% and 83.7%, respectively. The proportion of prostate cancer deaths during years 1-10 and 10-20 were 60.3% and 33.1%, respectively.
Clark R, Narod S. Patterns of mortality after prostate cancer: A SEER-based analysis. Presented at the Society of Urologic Oncology 22nd annual meeting, December 1-3, 2021. Poster 224.