Weiner Adam B, Li Eric V, Desai Anuj S, Press David J, Schaeffer Edward M
Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Cancer. 2021 Aug 15;127(16):2895-2904. doi: 10.1002/cncr.33584. Epub 2021 Apr 21.
More than 3.6 million men in the United States harbor a diagnosis of prostate cancer (PCa). The authors sought to provide in-depth analyses of the causes of death for contemporary survivors.
The authors performed a population-based cohort study in the United States (2000-2016) to assess causes of death for men diagnosed with PCa stratified by demographics and tumor stage. Using general population data, they calculated standardized mortality ratios (SMRs) as observed-to-expected death ratios.
In total, 752,092 men with PCa, including 200,302 who died (27%), were assessed. A total of 29,048 men with local/regional disease (17%) died of PCa, whereas more than 4-fold men died of other causes (n = 143,719 [83%]). SMRs for death from noncancer causes (0.77; 95% confidence interval [CI], 0.77-0.78) suggested that these men were less likely than the general population to die of most other causes. The most common noncancer cause of death was cardiac-related (23%; SMR, 0.76; 95% CI, 0.75-0.77). Among men with distant PCa, 90% of deaths occurred within 5 years of diagnosis. Although deaths due to PCa composed the majority of deaths (74%), SMRs suggested that men with distant PCa were at heightened risk for death from most other noncancer causes (1.50; 95% CI, 1.46-1.54) and, in particular, for cardiac-related death (SMR, 1.48; 95% CI, 1.41-1.54) and suicide (SMR, 2.32; 95% CI, 1.78-2.96). Further analyses demonstrated that causes of death varied by patient demographics.
Causes of death during PCa survivorship vary by patient and tumor characteristics. These data provide valuable information regarding health care prioritization during PCa survivorship.
Men with early-stage prostate cancer are 4-fold more likely to die of other causes, whereas those with advanced prostate cancer are at increased risk for several causes not related to prostate cancer in comparison with the general population. These findings can help guide physicians taking care of men with a diagnosis of prostate cancer.
美国有超过360万男性被诊断患有前列腺癌（PCa）。作者试图对当代幸存者的死因进行深入分析。
作者在美国进行了一项基于人群的队列研究（2000 - 2016年），以评估按人口统计学和肿瘤分期分层的PCa男性患者的死因。利用一般人群数据，他们计算了标准化死亡率（SMRs），即观察到的死亡与预期死亡的比率。
总共评估了752,092名PCa男性患者，其中200,302人死亡（27%）。共有29,048名患有局部/区域疾病的男性（17%）死于PCa，而死于其他原因的男性人数超过4倍（n = 143,719 [83%]）。非癌症原因导致的死亡标准化死亡率（0.77；95%置信区间[CI]，0.77 - 0.78）表明，这些男性死于大多数其他原因的可能性低于一般人群。最常见的非癌症死因是心脏相关（23%；标准化死亡率，0.76；95%置信区间，0.75 - 0.77）。在患有远处转移PCa的男性中，90%的死亡发生在诊断后的5年内。尽管PCa导致的死亡占大多数（74%），但标准化死亡率表明，患有远处转移PCa的男性死于大多数其他非癌症原因的风险更高（1.50；95%置信区间，1.46 - 1.54），尤其是心脏相关死亡（标准化死亡率，1.48；95%置信区间，1.41 - 1.54）和自杀（标准化死亡率，2.32；95%置信区间，1.78 - 2.96）。进一步分析表明，死因因患者人口统计学特征而异。
PCa幸存者的死因因患者和肿瘤特征而异。这些数据为PCa幸存者期间的医疗保健优先级提供了有价值的信息。
早期前列腺癌男性死于其他原因的可能性高出4倍，而晚期前列腺癌男性与一般人群相比，死于几种与前列腺癌无关原因的风险增加。这些发现有助于指导照顾被诊断患有前列腺癌男性的医生。
