Temporal Trends in Cause of Death Among Swedish and US Men with Prostate Cancer
Temporal Trends in Cause of Death Among Swedish and US Men with Prostate Cancer
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DOI：
10.1093/jnci/djs299
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发表时间：
2012-09-01
影响因子：
10.3
通讯作者：
Adami, Hans-Olov
中科院分区：
文献类型：
--
作者：
Epstein, Mara M.;Edgren, Gustaf;Adami, Hans-Olov
越来越多的通过前列腺特异性抗原检测被诊断患有局限性前列腺癌的男性死于前列腺癌以外的原因。我们分析了瑞典全国范围内癌症登记处（1961 - 2008; n = 210 - 112）和美国监测、流行病学和最终结果项目（1973 - 2008; n = 490 - 341）中记录的所有前列腺癌病例的死亡原因。我们计算了七种选定原因的累积死亡率，这些原因占报告死亡的80%以上（包括缺血性心脏病和非前列腺癌），并按日历年、诊断时的年龄和随访时间长短分析死亡率趋势。前列腺癌占瑞典所有报告死亡人数的52%，占美国前列腺癌男性报告死亡人数的30%;然而，只有35%的瑞典男性和16%的美国男性被诊断患有前列腺癌，死于这种疾病。在这两个人群中，前列腺癌特异性死亡的累积发生率在随访期间下降，而缺血性心脏病和非前列腺癌死亡的累积发生率保持不变。在瑞典和美国，前列腺癌的5年累积死亡率分别为29%和11%。在瑞典和美国，诊断为前列腺癌的男性死于前列腺癌的可能性低于其他原因。由于许多其他死亡原因可以通过改变生活方式来预防，因此应将针对生活方式因素的干预措施纳入前列腺癌管理。
A growing proportion of men diagnosed with localized prostate cancer detected through prostate-specific antigen testing are dying from causes other than prostate cancer. Temporal trends in specific causes of death among prostate cancer patients have not been well described.We analyzed causes of death among all incident prostate cancer cases recorded in the nationwide Swedish Cancer Registry (19612008; n = 210 112) and in the US Surveillance, Epidemiology, and End Results Program (19732008; n = 490 341). We calculated the cumulative incidence of death due to seven selected causes that accounted for more than 80% of the reported deaths (including ischemic heart disease and nonprostate cancer) and analyzed mortality trends by calendar year and age at diagnosis and length of follow-up.During follow-up through 2008, prostate cancer accounted for 52% of all reported deaths in Sweden and 30% of reported deaths in the United States among men with prostate cancer; however, only 35% of Swedish men and 16% of US men diagnosed with prostate cancer died from this disease. In both populations, the cumulative incidence of prostate cancerspecific death declined during follow-up, while the cumulative incidences of death from ischemic heart disease and nonprostate cancer remained constant. The 5-year cumulative incidence of death from prostate cancer among all men was 29% in Sweden and 11% in the United States.In Sweden and the United States, men diagnosed with prostate cancer are less likely to die from prostate cancer than from another cause. Because many of these other causes of death are preventable through changes in lifestyle, interventions that target lifestyle factors should be integrated into prostate cancer management.