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. 2022 Jul 1:12:914875.
doi: 10.3389/fonc.2022.914875. eCollection 2022.

Causes of Death Among Prostate Cancer Patients Aged 40 Years and Older in the United States

Yuzhong Ye  1 , Yongqiang Zheng  2 , Qi Miao  1 , Hailong Ruan  1 , Xiaoping Zhang  1
Affiliations

Causes of Death Among Prostate Cancer Patients Aged 40 Years and Older in the United States

Yuzhong Ye et al. Front Oncol. .

Abstract

Purpose: Little is known about the detailed spectrum of the cause of death associated with prostate cancer (PCa). This study systematically characterized the cause of death among patients with PCa.

Methods: Patients aged 40 years and older with primary PCa were identified from the Surveillance, Epidemiology, and End Results program. Mortality rates were estimated. Standardized mortality ratios (SMRs) of non-cancer deaths were calculated to evaluate the risk of death and to compare with the cancer-free population.

Results: This study included 1,170,489 patients with PCa. There were 501,262 deaths, of which 27.4% were due to PCa and 57.0% were due to non-cancer causes. Non-cancer deaths increased over time from 1975 to 2016, and index cancer death decreased continually. The risk of non-cancer deaths was 1.45 times (SMR, 1.45; 95% confidence interval [CI], 1.45-1.46) that of the general population. Cardiovascular disease was the most common non-cancer cause of death, accounting for 30.2% of all deaths among PCa patients. Alzheimer's disease (SMR, 3.92; 95% CI, 3.85-4.00) had the highest risk of death. The mortality rate and SMR of non-cancer deaths increased with increased follow-up after diagnosis.

Conclusion: Instead of the index cancer, non-cancer comorbidities were the leading cause of death among patients with PCa, and the risk of non-cancer deaths was much higher than among the general population. Clinicians and researchers should be aware of this trend to conduct timely and targeted interventions.

Keywords: Surveillance Epidemiology and End Results database; cardiovascular diseases; cause of death; chronic obstructive pulmonary disease and allied cond; non-cancer deaths; prostate cancer.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of case inclusion and exclusion criteria.
Figure 2
Figure 2
Forest plot showing the SMRs of different non-cancer of death in ranked order.
Figure 3
Figure 3
Cause of death by year of death and time after diagnosis. (A) Cause of death by year of death. (B) Cause of death by time after diagnosis.
Figure 4
Figure 4
Cumulative mortality rate (SMR) by time after diagnosis.
See this image and copyright information in PMC

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