234 PROSTATE CANCER DEATHS: CLINICAL AND DEMOGRAPHIC CHARACTERISTICS OVER TIME DURING THE PSA ERA

Abstract

You have accessJournal of UrologyProstate Cancer: Epidemiology & Natural History (I)1 Apr 2013234 PROSTATE CANCER DEATHS: CLINICAL AND DEMOGRAPHIC CHARACTERISTICS OVER TIME DURING THE PSA ERA Jennifer Wu, Kari Fish, Ralph DeVere White, and Marc Dall'Era Jennifer WuJennifer Wu Sacramento, CA More articles by this author , Kari FishKari Fish Sacramento, CA More articles by this author , Ralph DeVere WhiteRalph DeVere White Sacramento, CA More articles by this author , and Marc Dall'EraMarc Dall'Era Sacramento, CA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.1614AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Prostate cancer mortality rates have declined modestly since the advent of PSA screening. The reasons for this are likely multifactorial. We sought to better understand the characteristics of contemporary men who die from prostate cancer compared to those prior to PSA screening. METHODS Data were obtained from the California Cancer Registry, a statewide population based dataset. All men dying of prostate cancer from 1988-2009 were identified. Men were stratified into quintiles by year of death for comparison of clinical and demographic characteristics at the time of diagnosis. A multivariate analysis was performed to determine predictors of all cause and prostate cancer specific mortality while adjusting for multiple covariates. RESULTS Between 1988 and 2009, there were 38,016 deaths from prostate cancer. The prostate cancer mortality rate declined from 102.3 per 100,000 at risk between 1988 and 1992 to 67 per 100,000 between 2004 and 2009. The median age of death for men dying from prostate cancer rose over the period of study from age 75 in 1988-1992 to 79 for contemporary men (p<0.0001). The median age of diagnosis has decreased from 73 to 71 over this period (p<0.0001)(Fig.1). Fifty five percent of contemporary men dying from prostate cancer presented with clinically localized disease as compared with only 17% from the pre-PSA era (Fig. 2). Five percent of contemporary men who die from prostate cancer presented with well differentiated (WHO grade 1) disease while 50% percent of men presented with high grade (WHO 3/4) disease. On multivariate analysis age, race, socioeconomic status, grade, and year of diagnosis were all independently associated with prostate cancer mortality. CONCLUSIONS Contemporary men dying of prostate cancer are diagnosed younger and living to an older age than historically. More than 50% of men dying of prostate cancer today present with clinically localized disease suggesting inadequate initial treatment despite PSA screening. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e96 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jennifer Wu Sacramento, CA More articles by this author Kari Fish Sacramento, CA More articles by this author Ralph DeVere White Sacramento, CA More articles by this author Marc Dall'Era Sacramento, CA More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...