scholarly journals Incidence and mortality trends of metastatic prostate cancer: Surveillance, Epidemiology, and End Results database analysis

2021 ◽  
Vol 15 (12) ◽  
Author(s):  
Aaron C. Zhang ◽  
Rehana Rasul ◽  
Anne Golden ◽  
Michael A. Feuerstein
Keyword(s):  
Prostate Cancer ◽  
Metastatic Prostate Cancer ◽  
Incidence Rates ◽  
Poverty Level ◽  
Increased Risk ◽  
Incidence And Mortality ◽  
Specific Mortality ◽  
Cancer Specific Mortality ◽  
The Impact ◽  
End Results

Introduction: In the past decade, prostate cancer screening decreased, raising the concern of delays in diagnosis and leading to increase in new cases of metastatic prostate cancer. This study evaluated whether these changes may have impacted trends in metastatic prostate cancer incidence and survival. Methods: Metastatic prostate cancer diagnoses from 2008–2016 were identified from the Surveillance, Epidemiology, and End Results (SEER) 18 registries. Age-adjusted incidence rates per 100 000 were calculated by time periods and demographic variables. Two-year all-cause and prostate cancer-specific mortality were calculated for patients diagnosed from 2008–2014, and multivariable Cox proportional hazards models were used to evaluate the impact of demographic and clinical variables. Results: Incidence rates of metastatic prostate cancer increased by 18% from 2008–2009 to 2014–2016 (Incidence rate ratio [IRR]=1.18, 95% confidence interval [CI] 1.14–1.21). This trend was observed across multiple subgroups but was greatest in non-Hispanic Whites and patients living in counties 0–10% below poverty level. There was an overall decreased risk of all-cause and prostate cancer-specific mortality, but unmarried men and men living in counties >20% below poverty level showed statistically significant increased risk of prostate cancer-specific mortality. Conclusions: Non-Hispanic Whites and the wealthiest subgroups had the largest increase in incidence of metastatic prostate cancer since 2008. Despite trends of decreased risk of prostate cancer-specific mortality, we found certain populations experienced increases in mortality risk. Studies exploring the role of socioeconomic factors on screening and access to newer treatments are needed.

Advanced age and prostate cancer specific mortality among geriatric patients with metastatic prostate cancer.

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 319-319
Author(s):  
Grace L. Lu-Yao ◽  
William Kevin Kelly ◽  
Andrew E. Chapman
Keyword(s):  
Prostate Cancer ◽  
Clinical Trials ◽  
General Population ◽  
Metastatic Prostate Cancer ◽  
Geriatric Patients ◽  
Primary Cancer ◽  
Seer Database ◽  
Increased Risk ◽  
Specific Mortality ◽  
Cancer Specific Mortality

319 Background: Data from clinical trials has shown that octogenarians are at increased risk for prostate cancer specific mortality (PCSM). Patients with significant comorbidities were excluded from the trials; consequently, the findings from clinical trials may not be applicable to the general population. Data on patients age 80+ with metastatic prostate cancer in the general population are limited. This population-based study assesses PCSM for metastatic prostate cancer patients diagnosed at age 70+. Methods: Using the Surveillance, Epidemiology, and End Results (SEER) database, identified 418,982 patients diagnosed with prostate cancer at age 70+ between 01/01/2004-12/31/13, of which 12,749 had metastatic prostate cancer. The SEER database covers about 28% of the US population from all racial/ethnic groups. We used Cox proportional hazards (PH) model to calculate cause specific hazard ratio adjusted by age, race, marital status, urban-rural classification, income level, insurance type, primary cancer therapy, stage, and diagnosis period. Results: Of the 12,749 patients, 49.4% of the patients were in their 70's and 8.3% in their 90's+, with 79.1% of patients white and 57.1% married. About 17% of these patients received radiotherapy as their primary cancer treatment. The distribution of M1 subtype is: M1a (4.2%), M1b (68.5%), M1c (22.7%), M1 Not Otherwise Specified (or NOS,4.6%). The median survival for patients with M1 prostate cancer aged 70-79, 80-89 and 90+ were 25, 15, and 7 months, respectively. Compared to patients diagnosed in their 70's, there was 38% and 109% increase in PCSM among those diagnosed at ages 80-89 and 90+ respectively (Table). Conclusions: PCSM increases among geriatric patients with metastatic prostate cancer after accounting for potential confounding factors. Further investigation is needed to shed light on the underlying biological mechanisms. [Table: see text]

scholarly journals Effects of cancer screening restart strategies after COVID-19 disruption

2021 ◽  
Vol 124 (9) ◽  
pp. 1516-1523
Author(s):  
Lindy M. Kregting ◽  
Sylvia Kaljouw ◽  
Lucie de Jonge ◽  
Erik E. L. Jansen ◽  
Elleke F. P. Peterse ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Catching Up ◽  
Incidence And Mortality ◽  
Specific Mortality ◽  
Cancer Specific Mortality ◽  
Catch Up ◽  
Microsimulation Models ◽  
The Impact

Abstract Background Many breast, cervical, and colorectal cancer screening programmes were disrupted due to the COVID-19 pandemic. This study aimed to estimate the effects of five restart strategies after the disruption on required screening capacity and cancer burden. Methods Microsimulation models simulated five restart strategies for breast, cervical, and colorectal cancer screening. The models estimated required screening capacity, cancer incidence, and cancer-specific mortality after a disruption of 6 months. The restart strategies varied in whether screens were caught up or not and, if so, immediately or delayed, and whether the upper age limit was increased. Results The disruption in screening programmes without catch-up of missed screens led to an increase of 2.0, 0.3, and 2.5 cancer deaths per 100 000 individuals in 10 years in breast, cervical, and colorectal cancer, respectively. Immediately catching-up missed screens minimised the impact of the disruption but required a surge in screening capacity. Delaying screening, but still offering all screening rounds gave the best balance between required capacity, incidence, and mortality. Conclusions Strategies with the smallest loss in health effects were also the most burdensome for the screening organisations. Which strategy is preferred depends on the organisation and available capacity in a country.

Predictors of prostate cancer-specific mortality in elderly men with intermediate-risk prostate cancer treated with radiation therapy

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 9543-9543
Author(s):  
A. Nanda ◽  
M. Chen ◽  
B. J. Moran ◽  
M. H. Braccioforte ◽  
D. Dosoretz ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
External Beam Radiation ◽  
Intermediate Risk ◽  
Elderly Men ◽  
Beam Radiation ◽  
Increased Risk ◽  
Specific Mortality ◽  
Risk Prostate Cancer ◽  
Cancer Specific Mortality

9543 Background: To identify clinical factors associated with prostate cancer-specific mortality (PCSM), adjusting for co-morbidity, in elderly men with intermediate-risk prostate cancer treated with brachytherapy alone or in conjunction with external beam radiation therapy (EBRT). Methods: The study cohort comprised 1,978 men of median age 71 (interquartile range [IQR], 66–75) years with intermediate-risk prostate cancer (Gleason score 7 with PSA 20 ng/mL or less and tumor category T2c or less). Fine and Gray's multivariable competing risks regression was used to assess whether presence of cardiovascular disease (CVD), age, treatment, year of brachytherapy, PSA level, or tumor category were associated with the risk of PCSM. Results: After a median follow up of 3.2 (IQR, 1.7 - 5.4) years, 15 men were observed to experience PCSM. The presence of CVD was significantly associated with a decreased risk of PCSM (AHR 0.20, 95% CI 0.04 - 0.99, P = 0.05), whereas an increasing PSA level was significantly associated with an increased risk of PCSM (AHR 1.14, 95% CI 1.02 - 1.27, P = 0.02). In the absence of CVD, cumulative incidence estimates of PCSM were higher (P = 0.03) in men with PSA levels above as compared to the median PSA level (7.3 ng/mL) or less; however, in the setting of CVD there was no difference (P = 0.27) in these estimates stratified by the median PSA level (6.9 ng/mL). Conclusions: Detection of intermediate-risk prostate cancer in elderly men without CVD at lower PSA levels is associated with a lower risk of PCSM; this risk reduction is not observed in men with known CVD. [Table: see text] No significant financial relationships to disclose.

Racial and age specific differences in localized and metastatic prostate cancer incidence: 1988-2013.

2017 ◽  
Vol 35 (6_suppl) ◽  
pp. 211-211
Author(s):  
Marc Dall'Era ◽  
Ralph deVere White ◽  
Danielle Rodgriguez ◽  
Rosemary Donaldson Cress
Keyword(s):  
Prostate Cancer ◽  
Cancer Incidence ◽  
Metastatic Prostate Cancer ◽  
Prostate Cancer Screening ◽  
The United States ◽  
Incidence Rates ◽  
Localized Prostate Cancer ◽  
Prostate Cancer Incidence ◽  
Race Ethnicity ◽  
The Impact

211 Background: The United States Preventive Services Task Force (USPSTF) recommended against routine PSA based prostate cancer screening in all men in 2012. This led to dramatic reductions in screening and rates of localized disease across all clinical risk groups. We sought to study the impact of this on rates of metastatic disease, specifically by patient race and age. Methods: We analyzed new prostate cancer incidence by stage at diagnosis between 1988-2013 within the Cancer Registry of Greater California. We further stratified cases by four major race/ethnicity groups (non-Hispanic white (NHW), non-Hispanic black (NHB), Hispanic and non-Hispanic Asian/PI (API)) and age. Incidence rates were calculated and compared per 100,000 and age-adjusted to the 2000 US Standard Population. Joinpoint regression was used to detect changes in incidence and to calculate the average percent change (APC). Results: Adjusted rates of remote prostate cancer incidence for NHW men increased slightly in the most recent decade (+0.28%) after steady declines in previous years with the inflection point occurring in 2002, however this was not statistically significant. In contrast, incidence of remote prostate cancer continued to decline for NHB (-2.73%), Hispanic (-2.04%), and API (-1.45%) men. The greatest increase of +1.1% a year since 2002 was observed for NHW men under age 65. The incidence of localized prostate cancer declined for all race/ethnicity groups over the most recent time period and also declined in all age groups. After remaining relatively flat since 1992, incidence of localized prostate cancer among NHW men declined by over 8% per year starting in 2007 compared with a more gradual decline of -3.52% a year since 2000 for NHB, and more recent declines of -14.41% and -16.64% for Hispanic and API men, respectively. Incidence of regional stage cancer also declined in all groups, but less dramatically. Conclusions: Incidence rates of newly metastatic prostate cancer have not significantly changed since PSA screening declined in the US although we noted a slight upward trend primarily for younger, white men since 2002.

Impact of marital status on prostate cancer-specific mortality and overall mortality after radical prostatectomy.

2012 ◽  
Vol 30 (5_suppl) ◽  
pp. 73-73
Author(s):  
Kenneth Gerard Nepple ◽  
Adam Stuart Kibel ◽  
Gurdarshan S Sandhu ◽  
Dorina Kallogjeri ◽  
Seth A. Strope ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Marital Status ◽  
Medical Comorbidity ◽  
Never Married ◽  
Increased Risk ◽  
Married Men ◽  
Specific Mortality ◽  
Cancer Specific Mortality ◽  
Overall Mortality

73 Background: Analysis from population-based cancer registry data has suggested that being married is associated with improved survival in men with prostate cancer. However, a limitation of such analysis is the inability to control for PSA or medical comorbidity which may differ by marital status. We investigated the association between marital status and both prostate cancer specific mortality (PCSM) and overall mortality (OM) in men treated with radical prostatectomy. Methods: The study population included 3596 men treated with radical prostatectomy at a single institution between 1994 and 2004 and followed for a median of 72 months. Disease specific factors (PSA, clinical stage, and biopsy Gleason grade), comorbidity (validated ACE-27 comorbidity index), ethnicity, age, and marital status at time of treatment were retrieved from an institutional cancer registry. Differences between marital status groups were evaluated by Chi square or ANOVA. Multivariable Cox proportional hazard regression models were used to estimate the hazard ratio (HR) of PCSM and OM by marital status. Results: 86.9% of men were married, 5.3% divorced, 2.4% widowed, and 5.5% never married. Marital status was associated with differences in PSA (p<0.01), comorbidity (p=0.04), and age (p<0.01). Married men had the lowest mean PSA at diagnosis and never married men were younger and the most likely to have no known medical comorbidity. A total of 386(11%) men were dead at the end of follow up, but only 55 of them died of prostate cancer. In multivariable analyses (Table), never married men had a significantly increased risk of PCSM and OM compared to married men, whereas no additional risk was observed for divorced or widowed men. Conclusions: Never married men had an increased risk of PCSM and OM. Factors associated with social isolation or unhealthy behaviors may have a detrimental effect on survival after prostatectomy. [Table: see text]

Cholesterol metabolism and prostate cancer-specific mortality.

2015 ◽  
Vol 33 (7_suppl) ◽  
pp. 12-12 ◽  
Author(s):  
Konrad Hermann Stopsack ◽  
Jennifer A. Sinnott ◽  
James Robert Cerhan ◽  
Lorelei A. Mucci ◽  
Jennifer R. Rider
Keyword(s):  
Prostate Cancer ◽  
Drug Use ◽  
Cholesterol Synthesis ◽  
Cholesterol Metabolism ◽  
Squalene Epoxidase ◽  
Cholesterol Lowering ◽  
Specific Mortality ◽  
Cancer Specific Mortality ◽  
The Mean ◽  
The Impact

12 Background: Cholesterol is needed in prostate cancer cells for cell proliferation and for androgen biosynthesis. Cholesterol-lowering statin drug use is associated with a lower risk of total and advanced prostate cancer and lower prostate cancer-specific mortality (PCSM). We hypothesized that tumor expression of cholesterol synthesis enzymes, transporters and regulators is associated with PCSM. Methods: We studied mRNA expression of 43 cholesterol metabolism genes in surgical specimens from 249 participants in the Health Professionals' Follow-up Study diagnosed with prostate cancer between 1986 and 2004. We included 81 cases of lethal prostate cancer and 168 indolent cases who survived >8 years without metastases. After multivariate dimensionality reduction for the synthesis, transport and regulator pathways using principal components analysis, we estimated odds ratios (ORs) and 95% confidence intervals (CIs) using logistic regression. We adjusted for age, year of diagnosis, body mass index, smoking status, family history, multivitamin use, high serum cholesterol and cholesterol-lowering drug use. Results: Reflecting the impact of the synthesis pathway and of the regulator pathway, respectively, the expression of squalene epoxidase (SQLE) and low-density lipoprotein receptor (LDLR) were significantly associated with lethal cancer in opposing directions. Compared to men with the mean level of SQLE expression, men with SQLE expression >1 standard deviation (SD) above the mean were 15.4 times more likely to have lethal cancer (95% CI: 3.31–71.53). For LDLR, expression >1 SD above the mean was associated with 96% lower odds of lethal cancer (95% CI: 0.01–0.70). Higher SQLE expression and lower LDLR expression were associated with higher Gleason grades (Fisher's test, p < 0.001 and p = 0.036, respectively) and were also predictive of PCSM independently from grade and tumor stage. Conclusions: These results suggest that the local cholesterol metabolism of the prostate tumor is tightly linked with mortality. Lethal cancers have higher activity of the second rate-controlling enzyme of cholesterol synthesis and are less dependent on cholesterol uptake.

Self-reported health and survival in older patients diagnosed with multiple myeloma.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 6582-6582
Author(s):  
Nadia Azmi Nabulsi ◽  
Ali Alobaidi ◽  
Brian Talon ◽  
Alemseged Ayele Asfaw ◽  
Jifang Zhou ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Medical Condition ◽  
Self Report ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Specific Mortality ◽  
Cancer Specific Mortality ◽  
Reported Health ◽  
Risk Of Cancer ◽  
The Impact

6582 Background: The strength of associations between pre-diagnosis self-reported health (SRH) and mortality differ by medical condition, with a moderately strong association reported among cancer patients. Less is known about the impact of SRH on survival among patients diagnosed with multiple myeloma (MM). We aimed to evaluate pre-diagnosis SRH in relation to survival in a cohort of older MM patients. Methods: We analyzed a prospective cohort from the Surveillance, Epidemiology, and End Results (SEER)-Medicare Health Outcomes Survey (MHOS) database of patients 65 years and older diagnosed with first primary MM. Survey responses to a single general health question (asking patients to self-report their health as excellent, very good, good, fair, or poor) were used to determine pre-diagnosis SRH, grouped as high (excellent/very good/good) or low (fair/poor). We used multivariable Cox proportional hazards models to estimate adjusted hazard ratios (HR) and 95% confidence intervals (CI) for associations between SRH and risks of all-cause and cancer-specific mortality. Results: Of 521 MM patients with pre-diagnosis SRH data, the mean (SD) age at diagnosis was 76.8 (6.1) years with 60% of patients identifying as white, 18% as black, and 32% reporting low SRH. Compared to patients reporting high SRH, patients reporting low SRH were older, had lower education levels, more comorbidities, and lower Veterans-RAND 12 physical health and mental health component summary scores. In multivariable analyses, MM patients with low SRH had a 28% increased risk of all-cause mortality (HR = 1.28, 95% CI = 1.00, 1.64) and a non-statistically significant 19% increased risk of cancer-specific mortality (HR = 1.19, 95% CI = 0.87, 1.61) compared to MM patients reporting high SRH. Conclusions: Our findings suggest that lower SRH is highly prevalent among MM patients prior to diagnosis and is associated with modestly increased all-cause mortality. At a minimum, low SRH deserves clinical attention to determine how older MM patients’ quality of life may be compromised. The mechanism by which SRH affects mortality in MM should be further assessed and efforts should be made to identify whether any of the underlying mechanisms linking SRH and mortality in MM are mutable.

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