Patient Demographics, Quality of Life, and Disease Features of Men With Newly Diagnosed Prostate Cancer: Trends in the PSA Era

Abstract

To describe how demographic and diagnostic characteristics of men with prostate cancer in the United States have changed since 1999, using data from the Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE) registry. The medical records of patients enrolled in CaPSURE between 1999 and 2011 were evaluated. Baseline demographics, disease features, and imaging use were assessed. Mantel-Haenszel chi-square was used to test for trends across diagnostic years. Between 1999 and 2011, a total of 9572 patients were diagnosed with prostate cancer and enrolled in CaPSURE at community (36), academic (3), and Veteran's Affairs (4) hospitals. Over the study period, mean age at diagnosis decreased, P<.01. In 2008-2011, a significant increase in diagnostic Gleason 7 or higher was observed relative to 1999-2001 (50% vs 36%, P<.01), congruent with recent guideline modifications of the Gleason classification system. An increase in the mean number of diagnostic biopsy cores (13.3 vs 8.3, P<.01) was also observed. A significant decrease in use of any imaging modality was seen (19% vs 45%, P<.01). Average pretreatment urinary and bowel function scores did not change, although there were significant increases in sexual function observed overall (P<.01). In the United States, several trends in the demographics and disease profile of men with newlydiagnosed prostate cancer were observed over the past 12 years. Decreased imaging use andincreased number of cores taken during diagnostic biopsy are in line with national urologic guidelines on prostate cancer diagnosis and management.