Men with early-stage prostate cancer (PCa) are far more likely to die from other causes, especially noncancer causes such as cardiac disease, according to a new study. The majority of men with advanced PCa die from their cancer.
Investigators said the study “provides the most contemporary and comprehensive evaluation of causes of death for men with PCa.” The findings are based on an analysis of data from 18 registries in the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) program.
The study examined the causes of death among 200,302 men with PCa. Of the 172,767 men with local or regional PCa, 29,048 (16.8%) died from PCa, whereas 33,176 (19.2%) died from other cancers and 110,543 (64%) died from noncancer causes, Adam B. Weiner, MD, of Northwestern University Feinberg School of Medicine in Chicago, and colleagues reported in Cancer. Cardiac-related illness was the most common noncancer cause of death (23.3%).
During follow-up, the risk of death overall was 10% lower for men with local or regional PCa compared with the general population, and, in particular, in the first year after diagnosis (42% lower).
Among the 27,535 men with distant PCa who died, PCa was the cause of death in 20,451 cases (74.3%). Another 1709 (6.2%) died from other cancers and 5375 (19.5%) died from noncancer causes. Results showed that 90% of deaths among men with distant PCa occurred within 5 years of diagnosis. In addition, compared with the general population, men with distant PCa were 1.5-fold more likely to die from noncancer causes, notably suicide and sepsis.
“Overall, our work highlights new opportunities to optimize overall health care management for men with distant PCa,” the authors wrote.
In an accompanying editorial, Joseph E. Bauer, PhD, of the Levine Cancer Institute/Atrium Health in Charlotte, North Carolina, praised the study by Dr Weiner and his collaborators.
“Their detailed account presents an increased awareness/sensitivity for clinical practitioners, including oncologists, radiation oncologists, urologists, and primary care physicians, among others.”
Dr Bauer added, “Think of their research findings as placing a bit more focus on noncancer causes of death in PCa survivors; this gives clinical practitioners the chance to affect the current mortality patterns by prioritizing health care management decisions.”
Weiner AB, Li EV, Desai AS, Press DJ, Schaeffer EM. Cause of death during prostate cancer survivorship: A contemporary, US population-based analysis. Published online April 21, 2021. Cancer. doi:10.1002/cncr.33584
Bauer JE. Prostate cancer survivorship, deaths, and health care management. Published online April 21, 2021. Cancer. doi:10.1002/cncr.33588