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. 2011;16(2):175-81.
doi: 10.1634/theoncologist.2010-0338. Epub 2011 Jan 21.

What do prostate cancer patients die of?

Matias Riihimäki  1 , Hauke Thomsen, Andreas Brandt, Jan Sundquist, Kari Hemminki
Affiliations

What do prostate cancer patients die of?

Matias Riihimäki et al. Oncologist. 2011.

Abstract

Background: A recent rise in the incidence of prostate cancer and a more favorable outcome have increased the proportions of other causes of death in affected men. Extending the survival of prostate cancer patients thus requires knowledge of all causes of death.

Methods: Data on the population, cancers, and causes of death were gathered from the nationwide Swedish Family-Cancer Database. A Cox regression model, comparing prostate cancer patients with all other men, was applied. Hazard ratios (HR) were calculated both for the underlying cause and for dying with a specific cause listed among multiple causes of death.

Findings: Among 686,500 observed deaths, 62,500 were prostate cancer patients. For underlying causes other than prostate cancer, the highest cause-specific HRs were found for external causes (HR, 1.24; 95% confidence interval [CI], 1.16-1.31), diseases of the pulmonary circulation (HR, 1.22; 95% CI, 1.09-1.37), and heart failure (HR, 1.18; 95% CI, 1.11-1.24). For specific multiple causes, the highest HRs were found for anemia (HR, 2.28; 95% CI, 2.14-2.42), diseases of the pulmonary circulation (HR, 1.61; 95% CI, 1.55-1.68), and urinary system disease (HR, 1.90; 95% CI, 1.84-1.96).

Interpretations: Prostate cancer patients have a higher risk for dying from various causes other than prostate cancer, including external causes and heart failure. Mechanisms have been proposed linking these elevated risks to both cancer and treatment. More attention should be paid to comorbidities in men with prostate cancer. The present study fulfills a gap in the knowledge of death causes in prostate cancer patients.

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Conflict of interest statement

Disclosures: Matias Riihimäki: None; Hauke Thomsen: None; Andreas Brandt: None; Jan Sundquist: None; Kari Hemminki: None.

The content of this article has been reviewed by independent peer reviewers to ensure that it is balanced, objective, and free from commercial bias. No financial relationships relevant to the content of this article have been disclosed by the authors or independent peer reviewers.

Figures

Figure 1.
Figure 1.
Number of death causes in deceased men with (gray) and without (black) prostate cancer.
See this image and copyright information in PMC

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