Prostate Cancer Deaths Occurring at Older Ages

SAN DIEGO—Men dying from prostate cancer (PCa) today are older than in the past, but they are living longer following local treatments for lower-risk disease, according to data presented at the American Urological Association annual meeting.

Among men who died from PCa, the median survival time from diagnosis improved by 43 months from the pre-PSA era to the post-PSA era.

Ross Anderson, MD, of XXXXXX, and colleagues analyzed data from the Surveillance, Epidemiology and End Results (SEER) to determine trends in age, race, disease risk, treatment, and survival time among men dying from PCa from 1983 to 2008. During the study period, 314,930 men were diagnosed with PCa and 140,675 died.

The proportion of men who died from PCa decreased from 44.5% in 1983 to 18.9% in 2008, the investigators reported. Among men who died from PCa in the post-PSA era (1993-2002), the median age was 79 years compared with 76 years in the pre-PSA era (1983-1987). Men who died from PCa were more racially diverse in the post-PSA period, with fewer Caucasians (80%) when compared with the pre-PSA period (83%).

In addition, compared with men who died from PCa in the pre-PSA period, those who died from PCa in the post-PSA era were almost twice as likely to have presented with organ-confined disease (61% vs. 34%) and twice as likely to have been treated with definitive local therapies (48% vs. 22%).

Separately, in a study of men who died from PCa in California from 1988-2009, Jennifer Wu, MD, and colleagues at the University of California Medical Center in Sacramento found that the PCa mortality rate decreased from 102.3 deaths per 100,000 men at risk from 1988-1992 to 67 per 100,000 from 2004-2009. The median age of death among men who died from PCa rose from 75 years in 1988-1992 to 79 in the post-PSA era. The study also found that 55% of men in the post-PSA era who died from PCa present with clinically localized disease compared with 17% in the pre-PSA era, suggesting inadequate initial treatment despite PSA screening, the researchers concluded.