Cause of death in older men after the diagnosis of prostate cancer.

Abstract

To compare survival and cause of death in men aged 65 and older diagnosed with prostate cancer and with survival and cause of death in a noncancer control population. Retrospective cohort from a population-based tumor registry linked to Medicare claims data. Eleven regions of the Surveillance, Epidemiology and End Results (SEER) Tumor Registry. Men aged 65 to 84 (N=208,601) diagnosed with prostate cancer from 1988 through 2002 formed the basis for different analytical cohorts. Survival as a function of stage and tumor grade (low, Gleason grade<7; moderate, grade=7; and high, grade=8-10) was compared with survival in men without any cancer using Cox proportional hazards regression. Cause of death according to stage and tumor grade were compared using chi-square statistics. Men with early-stage prostate cancer and with low- to moderate-grade tumors (59.1% of the entire sample) experienced a survival not substantially worse than men without prostate cancer. In those men, cardiovascular disease and other cancers were the leading causes of death. The excellent survival of older men with early-stage, low- to moderate-grade prostate cancer, along with the patterns of causes of death, implies that this population would be well served by an ongoing focus on screening and prevention of cardiovascular disease and other cancers.