Survival in prostate carcinoma—Outcomes from a prospective, population‐based cohort of 8887 men with up to 15 years of follow‐up

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Abstract
BACKGROUND To decide on screening strategies and curative treatments for prostate carcinoma, it is necessary to determine the incidence and survival in a population that is not screened. METHODS The 15‐year projected survival data were analyzed from a prospective, complete, population‐based registry of 8887 patients with newly diagnosed prostate carcinoma from 1987 to 1999. RESULTS The median patient age at diagnosis was 75 years (range, 40–96 years), and 12% of patients were diagnosed before the age 65 years. The median follow‐up was 80 months for patients who remained alive. In total, 5873 of 8887 patients (66.1%) had died, and 2595 of those patients (44.2%) died directly due to prostate carcinoma. The overall median age at death was 80 years (range, 41–100 years). The projected 15‐year disease‐specific survival rate was 44% for the whole population. In total, 18% of patients had metastases at diagnosis (M1), and their median survival was 2.5 years. Patients with nonmetastatic T1–T3 prostate carcinoma (age < 75 years at diagnosis; n = 2098 patients) had a 15‐year projected disease‐specific survival rate of 66%. Patients who underwent radical prostatectomy had a significantly lower risk of dying from prostate carcinoma (relative risk, 0.40) compared with patients who were treated with noncurative therapies or radiotherapy. CONCLUSIONS The disease‐specific mortality was comparatively high, but it took 15 years to reach a disease‐specific mortality rate of 56%. These data form a truly population‐based baseline on how prostate carcinoma will affect a population when screening is not applied and can be used for comparison with other health care strategies. Cancer 2005. © 2005 American Cancer Society.

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