Causes of Death Among Prostate Cancer Patients Aged 40 Years and Older in the United States

Abstract

PurposeLittle is known about the detailed spectrum of the cause of death associated with prostate cancer (PCa). This study systematically characterized the cause of death among patients with PCa.MethodsPatients aged 40 years and older with primary PCa were identified from the Surveillance, Epidemiology, and End Results program. Mortality rates were estimated. Standardized mortality ratios (SMRs) of non-cancer deaths were calculated to evaluate the risk of death and to compare with the cancer-free population.ResultsThis study included 1,170,489 patients with PCa. There were 501,262 deaths, of which 27.4% were due to PCa and 57.0% were due to non-cancer causes. Non-cancer deaths increased over time from 1975 to 2016, and index cancer death decreased continually. The risk of non-cancer deaths was 1.45 times (SMR, 1.45; 95% confidence interval [CI], 1.45–1.46) that of the general population. Cardiovascular disease was the most common non-cancer cause of death, accounting for 30.2% of all deaths among PCa patients. Alzheimer’s disease (SMR, 3.92; 95% CI, 3.85–4.00) had the highest risk of death. The mortality rate and SMR of non-cancer deaths increased with increased follow-up after diagnosis.ConclusionInstead of the index cancer, non-cancer comorbidities were the leading cause of death among patients with PCa, and the risk of non-cancer deaths was much higher than among the general population. Clinicians and researchers should be aware of this trend to conduct timely and targeted interventions.

Safety, Pharmacokinetic and Pharmacodynamic Evaluation of Teverelix for the Treatment of Hormone-Sensitive Advanced Prostate Cancer: Phase 2 Loading-Dose-Finding Studies

“…In the United States, cardiovascular disease is the main cause of death for prostate cancer patients, and patients with prostate cancer have a higher risk of death from noncancer causes than the general population [26]. ADT is associated with a number of cardiometabolic side effects including decreased insulin sensitivity, changes in lipid profile, and an increased risk of thromboembolic and cerebrovascular events [27].…”

Relative Burden of Cancer and Noncancer Mortality Among Long-Term Survivors of Breast, Prostate, and Colorectal Cancer in the US

“…Due to improvements in early detection, treatment, and oncologic outcomes, many survivors of cancer are now living longer and are thus more likely to experience or die from conditions other than their original cancer, [1][2][3][4] with two-thirds of all patients with cancer now living 5 years or more after diagnosis. 5 Risk-stratified models of care have emerged as a critical strategy that could be used to appropriately allocate care intensity between the oncologist and primary care physician (PCP) [6][7][8][9][10] and has been highlighted by the American Cancer Society, the American Society of Clinical Oncology, and the National Cancer Institute as an area of priority research.…”

“…Given that breast, prostate, and colorectal cancers account for half of all diagnoses for survivors of cancer, individuals with these cancers provide the ideal study population for survivorship risk stratification research. 25,26 The ability to directly inform survivorship care is hampered in that these studies (1) often included patients who did not undergo curative treatment and/or had metastatic disease, (2) were not focused on long-term survivors (ie, those surviving at Ն5 years from diagnosis), (3) did not attempt to differentiate factors associated with cancer-specific vs noncancer-specific mortality, and (4) did not define cancer-specific vs noncancer-specific events from an optimal surveillance perspective. As such, relevant empirical data are lacking to inform long-term survivors of these common cancers of their relative risk of cancer-specific vs noncancer-specific mortality, which could be used to help inform models of survivorship care that are tailored to patients' unique risk profiles.…”

Evolving imaging methods of prostate cancer and the emergence of magnetic resonance imaging guided ablation techniques

“…Although PCa is the sixth leading cause of cancer-related death in men worldwide, the disease is frequently chronic in a large proportion, and many men die of reasons other than PCa ( 1 , 3 ). In addition to the development of diagnostics and treatments, this is explained by the relatively slow natural course of PCa.…”