Approximately 1 in 6 deaths among men with metastatic prostate cancer are due to noncancer causes, according to a recent study.

Cardiovascular and cerebrovascular diseases and chronic obstructive pulmonary disease (COPD) are among the most common noncancer causes of death.

“These findings may provide insight into how men with metastatic [prostate cancer] should be counseled regarding future health risks and highlight the importance of multidisciplinary care for such patients,” a team led by Omar Alhalabi, MD, of the University of Texas MD Anderson Cancer Center in Houston, reported in JAMA Network Open.

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Using data from the Surveillance, Epidemiology, and End Results (SEER) program database, the investigators studied 26,168 men diagnosed with metastatic prostate cancer from January 1, 2000, to December 31, 2016. Of these, 16,732 (63.9%) died during follow-up. Most deaths (59%) occurred within 2 years of diagnosis. The mean age at death was 74 years.

Of the total number of deaths following a diagnosis of metastatic prostate cancer, 13,011 (77.8%) were from prostate cancer, 924 (5.5%) were from other cancers, and 2797 (16.7%) were from noncancer causes, Dr Alhalabi and colleagues reported.

Men with metastatic prostate cancer had a significant 34%, 31%, and 19% higher mortality rate from cardiovascular disease, cerebrovascular disease, and COPD, respectively, compared with the age-matched US male population in adjusted analyses, according to the investigators.

Men younger than 50 years at the time of diagnosis of metastatic prostate cancer had a higher overall risk for death within 2 years after diagnosis compared with men younger than 50 years without metastatic prostate cancer, Dr Alhalabi’s team reported.

White patients and Asian and Pacific Islander patients had a significantly increased risk for death by suicide, whereas Black patients and American Indian and Alaska Native patients did not.

In an accompanying editorial, Samuel W.D. Merriel, MSc, of the University of Exeter Medical School in Exeter, UK, and coauthors noted that, as the study investigators observed, most men with metastatic prostate cancer die from it instead of other possible causes of death, “reinforcing the need for innovations to promote early-stage diagnosis. The recent developments and implementation of new tests for prostate cancer detection may reduce the proportion of patients who receive a diagnosis at a late stage, although some metastatic disease at the time of diagnosis will likely still occur.”

The editorialists also commented, “Their finding of increased suicide rates among Asian or Pacific Island patients and White patients with metastatic prostate cancer is a surprise and should be investigated further, considering that such deaths are potentially preventable.”


Elmehrath AO, Afifi AM, Al-Husseini MJ, et al. Causes of death among patients with metastatic prostate cancer in the US from 2000 to 2016. JAMA Netw Open. Published online August 5, 2021. doi:10.1001/jamanetworkopen.2021.19568

Mereriel SWD, Martins T, Bailey SER. Exploring the causes of death among patients with metastatic prostate cancer—a changing landscape. JAMA Netw Open. Published online August 5, 2021. doi:10.1001/jamanetworkopen.2021.20889