Prostate cancer screening and mortality of prostate cancer patients ...

Posted on March 14, 2012 by Sitemaster

A newly published, retrospective analysis of mortality data from participants in the European Randomized Study of Screening for Prostate Cancer (ERSPC) trial suggests the possibility that men diagnosed with clinical symptoms of prostate cancer are at higher risk for non-prostate cancer-related mortality than men diagnosed through a screening protocol.

It is well understood that hormonal treatment of advanced prostate cancer may place some patients at significant risk of cardiovascular events. Furthermore, some recent studies have indicated that men diagnosed with screening-detected prostate cancer are at lower risk for such cardiovascular events than men with clinically diagnosed prostate cancer, and that that risk reduction may be associated with the use of medications for cardiovascular disease and the change to a healthier lifestyle among men with screening-detected prostate cancer.

van Leeuwen et al. therefore decided to carry out a retrospective analysis of data from the ERSPC trial to estimate the cause-specific mortality rates unrelated to prostate cancer itself in patients with screening- and clinically diagnosed prostate cancer.

All patients who died from prostate cancer in the ERSPC trial were excluded from the analysis. The authors then categorized all the other men who died (of any cause) into two groups:

• Group A comprised men aged between 55 and 74 years who were diagnosed with screening-detected prostate cancer between 1993 and 2001. These men were each matched to two men in Group B1 (men in whom no cancer was found after biopsy), and two men in Group B2 (men in whom no cancer was suspected after screening).
• Group C comprised men aged between 55 and 74 years of age who were unscreened but were diagnosed with prostate cancer based on their clinical symptoms between 1993 and 2001. These men were each matched to four men in Group D (men without prostate cancer).

All patient matching was carried out with respect to date of birth, screening, and/or diagnosis. All patients were followed through December 31, 2007.

Here are the key findings of the re-analysis:

• There was no significant difference in overall mortality between men in Group A and men in Group B1 (relative risk [RR] = 1.26) or in Group B2 (RR = 1.13).
• For men in Group C, overall mortality was significantly higher than among men in Group D (RR = 1.43).
• The increased risk of dying from men in Group C as compared to men in Group D appeared to result from a higher rate of mortality from non-prostate cancer neoplasms and diseases of the circulatory or respiratory system among men in Group C (RR = 1.61).

The authors are careful to point out that interpretation of the results of this study is constrained by the relatively small sample size. Having said that, it does appear that there was a higher risk for non-prostate cancer mortality among men with clinically diagnosed prostate cancer compared to men with screening-detected prostate cancer. This could be interpreted to imply that the very process of going through screening for prostate cancer actually decreased the risk for overall mortality from any cause other than prostate cancer over the 14 years of this study for the men who were actually diagnosed with prostate cancer.

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Filed under: Diagnosis, Living with Prostate Cancer, Risk Tagged: | ERSPC, mortality, non-prostate cancer-specific, screening

Source: http://prostatecancerinfolink.net/2012/03/14/prostate-cancer-screening-and-mortality-of-prostate-cancer-patients-from-other-causes/

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