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Cancer Specific Mortality in Men Diagnosed with Prostate Cancer before Age 50 Years : A Nationwide Population Based Study

Thorstenson, Andreas; Garmo, Hans; Adolfsson, Jan and Bratt, Ola LU (2017) In Journal of Urology 197(1). p.61-66
Abstract

Purpose We compared clinical characteristics and cancer specific mortality in men diagnosed with prostate cancer before vs after age 50 years. Materials and Methods A total of 919 men 35 to 49 years old and 45,098 men 50 to 66 years old who were diagnosed with prostate cancer between 1998 and 2012 were identified in PCBaSe (Prostate Cancer data Base Sweden). Cancer specific mortality was compared among age groups (35 to 49, 50 to 59, 60 to 63 and 64 to 66 years) with and without adjusting for cancer characteristics, comorbidity and education in a multivariable Cox proportional hazards model. Results Clinical cancer characteristics indicated that most nonmetastatic cancer in men younger than 50 years was detected after prostate specific... (More)

Purpose We compared clinical characteristics and cancer specific mortality in men diagnosed with prostate cancer before vs after age 50 years. Materials and Methods A total of 919 men 35 to 49 years old and 45,098 men 50 to 66 years old who were diagnosed with prostate cancer between 1998 and 2012 were identified in PCBaSe (Prostate Cancer data Base Sweden). Cancer specific mortality was compared among age groups (35 to 49, 50 to 59, 60 to 63 and 64 to 66 years) with and without adjusting for cancer characteristics, comorbidity and education in a multivariable Cox proportional hazards model. Results Clinical cancer characteristics indicated that most nonmetastatic cancer in men younger than 50 years was detected after prostate specific antigen testing. The proportion of nonmetastatic vs metastatic disease at diagnosis was similar in all age groups. A strong association between younger age and poor prognosis was apparent in men in whom metastatic disease was diagnosed before age 50 to 55 years. The crude and adjusted HRs of cancer specific mortality were 1.41 (95% CI 1.12–1.79) and 1.28 (95% CI 1.01–1.62) in men diagnosed before age 50 and at age 50 to 59 years, respectively. In men with nonmetastatic disease crude cancer specific mortality increased with older age but adjusted cancer specific mortality was similar in all age groups. Conclusions Our findings suggest that an aggressive form of metastatic prostate cancer is particularly common in men younger than 50 to 55 years. Genetic studies and trials of intensified systemic treatment are warranted in this patient group.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
age groups, mortality, neoplasm metastasis, prognosis, prostatic neoplasms
in
Journal of Urology
volume
197
issue
1
pages
6 pages
publisher
Lippincott Williams & Wilkins
external identifiers
  • scopus:85003680887
  • wos:000389609100022
ISSN
0022-5347
DOI
10.1016/j.juro.2016.06.080
language
English
LU publication?
yes
id
3f7c3a7c-e814-49c3-bfcf-ba5b4f6960a8
date added to LUP
2016-12-28 14:01:13
date last changed
2018-03-11 04:36:02
@article{3f7c3a7c-e814-49c3-bfcf-ba5b4f6960a8,
  abstract     = {<p>Purpose We compared clinical characteristics and cancer specific mortality in men diagnosed with prostate cancer before vs after age 50 years. Materials and Methods A total of 919 men 35 to 49 years old and 45,098 men 50 to 66 years old who were diagnosed with prostate cancer between 1998 and 2012 were identified in PCBaSe (Prostate Cancer data Base Sweden). Cancer specific mortality was compared among age groups (35 to 49, 50 to 59, 60 to 63 and 64 to 66 years) with and without adjusting for cancer characteristics, comorbidity and education in a multivariable Cox proportional hazards model. Results Clinical cancer characteristics indicated that most nonmetastatic cancer in men younger than 50 years was detected after prostate specific antigen testing. The proportion of nonmetastatic vs metastatic disease at diagnosis was similar in all age groups. A strong association between younger age and poor prognosis was apparent in men in whom metastatic disease was diagnosed before age 50 to 55 years. The crude and adjusted HRs of cancer specific mortality were 1.41 (95% CI 1.12–1.79) and 1.28 (95% CI 1.01–1.62) in men diagnosed before age 50 and at age 50 to 59 years, respectively. In men with nonmetastatic disease crude cancer specific mortality increased with older age but adjusted cancer specific mortality was similar in all age groups. Conclusions Our findings suggest that an aggressive form of metastatic prostate cancer is particularly common in men younger than 50 to 55 years. Genetic studies and trials of intensified systemic treatment are warranted in this patient group.</p>},
  author       = {Thorstenson, Andreas and Garmo, Hans and Adolfsson, Jan and Bratt, Ola},
  issn         = {0022-5347},
  keyword      = {age groups,mortality,neoplasm metastasis,prognosis,prostatic neoplasms},
  language     = {eng},
  month        = {01},
  number       = {1},
  pages        = {61--66},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {Journal of Urology},
  title        = {Cancer Specific Mortality in Men Diagnosed with Prostate Cancer before Age 50 Years : A Nationwide Population Based Study},
  url          = {http://dx.doi.org/10.1016/j.juro.2016.06.080},
  volume       = {197},
  year         = {2017},
}