Introduction to Department of Defense Center for Prostate Disease Research Multicenter National Prostate Cancer Database, and analysis of changes in the PSA-era

Abstract

The Center for Prostate Disease Research (CPDR) database was developed to standardize the clinical procedures for patients with carcinoma of the prostate (CaP), and support retrospective and prospective studies on CaP within the military health care system. METHODS: A set of clinical forms recording diagnosis, treatments, follow-up, and necropsy information for CaP management was developed. A relational database with about 500 data fields for recording CaP status, clinical intervention and outcome was developed and installed in nine military facilities. As a demonstration of utility, the ages at diagnosis and death from CaP over the past 15 years were analyzed. RESULTS: As of the end of November 2000, the database has archived 242,227 records on 11,637 men. The mean number of follow-up visits per patient is presently 8.45 (98,323 total follow-up visits). A greater than 50% reduction in prostate cancer mortality was demonstrated. Dead/alive ratio is 21.1%. Prostate cancer specific mortality represents 30.1% of the total death population. The mean age at diagnosis decreased from 68.0 years in 1991 to 64.7 in 1999 (p<0.05). The age at death increased from 68.8 years before 1986 to 78.0 in 2000 (p<0.01). Mean surviving months between diagnosis and death is increased from 33.2 months before 1986 to 108.2 in 2000 (p<0.01). CONCLUSION: The CPDR database is suitable for analyzing epidemiological features of CaP, treatment efficacy, and for monitoring the quality of life of CaP patients. CaP detection and outcome is significantly improved in our military health care beneficiaries since the introduction of PSA and increased public awareness. Our goal is to accrue 20,000 men and follow them for 20 years.