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- Title
Causes of Death Among Patients With Metastatic Prostate Cancer in the US From 2000 to 2016.
- Authors
Elmehrath, Ahmed O.; Afifi, Ahmed M.; Al-Husseini, Muneer J.; Saad, Anas M.; Wilson, Nathaniel; Shohdy, Kyrillus S.; Pilie, Patrick; Sonbol, Mohamad Bassam; Alhalabi, Omar
- Abstract
This cohort study uses data from the Surveillance, Epidemiology, and End Results Program to identify the most common causes of death among US men diagnosed with metastatic prostate cancer from 2000 to 2016. Key Points: Question: What are the most common causes of death in patients diagnosed with metastatic prostate cancer (PC)? Findings: In this cohort study of 26 168 patients with metastatic PC, 16 732 died during the follow-up period. Of these deaths, 77.8% were from PC, 5.5% were from other cancers, and 16.7% were from noncancer causes, including cardiovascular diseases, chronic obstructive pulmonary disease, and cerebrovascular diseases. Meaning: These findings suggest that therapy and follow-up should be tailored to the needs of each patient with metastatic PC and counseling should be provided regarding future health risks. Importance: Owing to improved survival among US patients with prostate cancer (PC), patients tend to live long enough after a PC diagnosis for non–cancer-related comorbidities to be associated with their overall survival. Although studies have investigated causes of death among patients with localized PC, data are lacking regarding causes of death among patients with metastatic PC. Objective: To assess causes of death among US patients with metastatic PC from 2000 to 2016. Design, Setting, and Participants: This retrospective cohort study used data from the Surveillance, Epidemiology, and End Results Program database to analyze a sample of 26 168 US men who received a diagnosis of metastatic PC from January 1, 2000, to December 31, 2016. Data were analyzed from February 2 to July 28, 2020. Exposure: Diagnosis of metastatic PC. Main Outcomes and Measures: Standardized mortality ratios (SMRs) for different causes of death were calculated by dividing the observed number of deaths from each cause of death by the expected number of deaths in the age-matched US male population for the same period, adjusting for age and race/ethnicity. Results: Of 26 168 patients with metastatic PC included in the analysis, 48.9% were aged 50 to 70 years (mean age at diagnosis, 70.83 years); 74.5% were White individuals, and 72.7% received a diagnosis of stage M1b metastatic PC. A total of 16 732 patients (63.9%) died during the follow-up period. The mean age at death was 74.13 years. Most deaths (59.0%) occurred within the latency period of 2 years after diagnosis of metastatic PC, whereas 31.6% occurred 2 to 5 years after diagnosis and 9.4% occurred more than 5 years after diagnosis. Of the total deaths, 13 011 (77.8%) were from PC, 924 (5.5%) were from other cancers, and 2797 (16.7%) were from noncancer causes. During all latency periods, the most common noncancer causes of death were cardiovascular diseases (SMR, 1.34; 95% CI, 1.26-1.42), chronic obstructive pulmonary disease (SMR, 1.19; 95% CI, 1.03-1.36), and cerebrovascular diseases (SMR, 1.31; 95% CI, 1.13-1.50). Conclusions and Relevance: In this cohort study, deaths from noncancer causes, including cardiovascular disease, constituted a substantial number of deaths among men with metastatic PC. Therapy and follow-up should be tailored to the needs of each patient with metastatic PC, and counseling regarding future health risks should be provided.
- Subjects
UNITED States; MORTALITY risk factors; CAUSES of death; CONFIDENCE intervals; TIME; AGE distribution; METASTASIS; RETROSPECTIVE studies; CARDIOVASCULAR diseases; FISHER exact test; CANCER patients; DESCRIPTIVE statistics; SURVIVAL analysis (Biometry); PROSTATE tumors; LONGITUDINAL method
- Publication
JAMA Network Open, 2021, Vol 4, Issue 8, pe2119568
- ISSN
2574-3805
- Publication type
Article
- DOI
10.1001/jamanetworkopen.2021.19568