Pd30-10 Definitive and Sustained Increase in Prostate Cancer Metastases in the United States
Year: 2019
Type: article
Study design: Observational Study
Abstract: You have accessJournal of UrologyProstate Cancer: Epidemiology & Natural History I (PD30)1 Apr 2019PD30-10 DEFINITIVE AND SUSTAINED INCREASE IN PROSTATE CANCER METASTASES IN THE UNITED STATES Neal Patel*, Art Sedrakyan, Fernando Bianco, Ruth Etzioni, Michael Gorin, Wei-Chun Hsu, Paul Nguyen, Edward Schaeffer, Jonathan Shoag, Andrew Vickers, and Jim C. Hu Neal Patel*Neal Patel* More articles by this author , Art SedrakyanArt Sedrakyan More articles by this author , Fernando BiancoFernando Bianco More articles by this author , Ruth EtzioniRuth Etzioni More articles by this author , Michael GorinMichael Gorin More articles by this author , Wei-Chun HsuWei-Chun Hsu More articles by this author , Paul NguyenPaul Nguyen More articles by this author , Edward SchaefferEdward Schaeffer More articles by this author , Jonathan ShoagJonathan Shoag More articles by this author , Andrew VickersAndrew Vickers More articles by this author , and Jim C. HuJim C. Hu More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000556142.87942.c6AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: Although a significant increase in distant prostate cancer metastases at diagnosis was witnessed from 2011 to 2013 in the United States,these findings were met with justifiable skepticism due to concerns that the rise, following a decline from 2004 to 2011, may be due to random statistical variation. In this study, we sought to further examine the temporal trends in non-metastatic and distant metastases. METHODS: We analyzed SEER Collaborative Staging for the incidence per million U.S. men, standardized to the population in 2000, of non-metastatic disease (T1-T4N0M0) and distant metastasis (M1) for men aged 50-74 and ≥75 years during 2004-2015. T stage was determined clinically and N and M stage were based on combined information from clinical and pathological assessment, as determined by SEER. To account for missing stage, incidence rates were derived by applying the proportion of each disease stage to the total number of men diagnosed with prostate cancer.1 Temporal trends in incidence were visualized with restricted cubic spline or linear model by quarter. Incidence ratios (IR) with 95% confidence intervals (CI) were calculated relative to consecutive years (e.g. 2015 vs 2014) as done in prior temporal analysis studies.3,4 All analyses were performed using SAS v9.3 (SAS Institute, Cary, NC). RESULTS: The incidence of non-metastatic prostate cancer decreased from 4618.0 to 2977.7 per million in men aged 50-74 years and from 6919.3 to 3221.1 per million in men aged ≥75 years between 2004-2015 (Figure 1). On the other hand, the incidence of distant metastases gradually increased from 130.1 to 157.3 per million men aged 50-74 years between 2007-2015 after the slight decline between 2005-2007; and from 451.0 to 586.1 per million men aged ≥75 years between 2011-2015 after the progressive decline between 2004-2011. Notably, the incidence of distant metastasis significantly increased from 451.0 to 504.0 per million (IR: 1.12, 95% CI: 1.01-1.24) from 2011-2012 and 532.3 to 586.1 per million (IR: 1.10, 95% CI: 1.00-1.21) from 2014-2015 in men aged ≥75 years. CONCLUSIONS: In conclusion, we demonstrate a sustained and definitive increase in prostate cancer distant metastases in men aged ≥75 years. Although our observational study design cannot pinpoint the exact cause of this increase, which likely multi-factorial, this shift reverses declines in metastases at diagnoses that followed the advent of PSA screening. Continued, close monitoring of population-based shifts in disease presentation is needed to determine the downstream epidemiological sequelae on prostate cancer specific mortality. Source of Funding: Supported by The Frederick J. and Theresa Dow Wallace Fund of the New York Community Trust. NY, NY; Fort Lauderdale, FL; Seattle, WA; Baltimore, MD; NY, NY; Boston, MA; Evanston, IL; NY, NY© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e563-e563 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Neal Patel* More articles by this author Art Sedrakyan More articles by this author Fernando Bianco More articles by this author Ruth Etzioni More articles by this author Michael Gorin More articles by this author Wei-Chun Hsu More articles by this author Paul Nguyen More articles by this author Edward Schaeffer More articles by this author Jonathan Shoag More articles by this author Andrew Vickers More articles by this author Jim C. Hu More articles by this author Expand All Advertisement PDF downloadLoading ...
Source: The Journal of Urology
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2942325435