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October 25, 2011

Study: Age a big factor in prostate cancer deaths

Contrary to common belief, men age 75 and older are diagnosed with late-stage and more aggressive prostate cancer and thus die from the disease more often than younger men, according to a Medical Center analysis published online by the journal, Cancer.

The study is relevant in light of the recent controversy about prostate cancer screening. Earlier this month a government health panel said that healthy men age 50 and older should no longer be routinely tested for prostate cancer because the screening test in its current form does not save lives and sometimes leads to needless suffering and overtreatment. Patient advocates and many clinicians disagreed with the finding.

Although the Rochester study does not address screening directly, it does raise questions about the benefits of earlier detection among the elderly.

“Especially for older people, the belief is that if they are diagnosed with prostate cancer, it will grow slowly and they will die of something else,” says lead author Guan Wu, an assistant professor of Urology and of Pathology and Laboratory Medicine.

“We hope our study will raise awareness of the fact that older men are actually dying at high rates from prostate cancer,” he says. “With an aging population it is important to understand this, as doctors and patients will be embarking on more discussions about the pros and cons of treatment.”

Wu and colleagues studied the largest national cohort of cancer patients, the Surveillance, Epidemiology, and End Results database. They analyzed 464,918 records of men diagnosed with prostate cancer between 1998 and 2007.

The analysis showed that when age groups are broken down into smaller sections, men 75 or older represented only 16 percent of the male population above age 50 and 26 percent of all cases of prostate cancer—but 48 percent of cases of metastatic disease at diagnosis and 53 percent of all deaths. In general, higher-grade cancer seemed to increase with age, the study said.

The research was funded by the Ashley Family Foundation. Coinvestigators are Edward Messing, chair of the Department of Urology; Emil Scosyrev, an assistant professor of urology; Supriya Mohile, an assistant professor of medicine in hematology/oncology with a special interest in geriatrics; and Dragan Golijanin, a former faculty member in orology

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