Survival analysis of distant prostate cancer by decade (1973-1997) in the Detroit Metropolitan Surveillance, Epidemiology and End Results (SEER) Program registry: has outcome improved? (United States).
OBJECTIVE
The purpose of this study is to examine differences in survival after diagnosis with distant stage prostate cancer by decade of diagnosis.


METHODS
Subjects are 3337 Caucasian and 1947 African-American men with newly diagnosed primary distant stage prostate cancer between 1973 and 1997, with follow-up through 2001, from the Detroit SEER registry. The proportion of men within each category of each variable of interest is calculated. Relative survival is used to examine survival patterns over time. Kaplan-Meier and Cox proportional hazard models are also used to examine the relationship between decade of diagnosis and survival between short term (< or = 24 months) and long term (> 24 months) survivors.


RESULTS
Relative survival has increased over the past three decades although this trend is not statistically significant. Relative survival is similar by race and decreases with increasing grade of tumor. Survival for men living < or = 24 months after diagnosis is similar over time. However, for men living > 24 months after diagnosis, there is a significant difference over time (p < 0.0001).


CONCLUSIONS
In general, relative survival has been improving over the past three decades. However, it is the long term survivors (> 24 months) that are the primary contributors to this difference in survival by decade of diagnosis.
Division of Hematology/Oncology, Department of Internal Medicine, Wayne State University School of Medicine and the Barbara Ann Karmanos Cancer Institute, Detroit, Michigan 48201, USA. jbsloan@med.wayne.edu
Jill S
JS
Barnholtz-Sloan
Richard K
RK
Severson
Ulka
U
Vaishampayan
Maha
M
Hussain
D000328:Adult; D000368:Aged; D044383:Black People; D006801:Humans; D008297:Male; D008824:Michigan; D008875:Middle Aged; D016016:Proportional Hazards Models; D011471:Prostatic Neoplasms / Q000208:ethnology / Q000401:mortality* / Q000473:pathology; D018426:SEER Program; D014504:Urban Health; D044465:White People; D001741:Black or African American