title: Prostate cancer in men aged less than 50 years at diagnosis.
abstract: OBJECTIVE
  Prostate cancer (CaP) in younger men (age ≤50 years) appears to present differently compared with older men. This study describes CaP characteristics and outcomes in Australian young men.
  
  
  METHODS
  The South Australian Prostate Cancer Clinical Outcomes Collaborative database was used to identify men diagnosed with CaP 1998-2012. Men were stratified by age at diagnosis into groups ≤50, 50-70 and ≥70 years. Primary outcomes of cumulative biochemical recurrence (BCR) and cumulative prostate cancer-specific mortality (PCSM) were assessed at 5 and 10 years.
  
  
  RESULTS
  In total, 7018 men were included. At time of diagnosis, 182 (2.6 %) were aged ≤50 years. Median follow-up exceeded 4 years. Younger men had a greater proportion of T stage <2 disease, lower median PSA and higher rates of Gleason score <7 (all p < 0.001). They were more likely to experience active surveillance (AS) (4.9, 3.1, 1.5 %) or radical prostatectomy (RP) (70, 55, 8 %) and less likely radiotherapy (13, 24, 29 %) as their principal modality (all p < 0.001). Although only 4.9 % underwent AS, 48 % of men ≤50 years were eligible for AS. Men ≤50 years had both the lowest unadjusted cumulative BCR and PCSM at 10 years. After multivariate analysis, BCR was not significantly different. Sample size limited multivariate analysis of PCSM.
  
  
  CONCLUSIONS
  In our cohort, men ≤50 years with CaP had less aggressive clinical characteristics, but were more likely to undergo RP. They appear to experience lower unadjusted PCSM, but similar rates of adjusted BCR. Further studies are needed to assess whether AS is appropriately utilised in these men.
authors.affiliation: Austin Hospital, Melbourne, Australia. ned.kinnear@gmail.com.|Royal Adelaide Hospital, Adelaide, Australia. ned.kinnear@gmail.com.
authors.forename: N J
authors.initials: NJ
authors.lastname: Kinnear
authors.affiliation: Flinders Centre for Innovation in Cancer, Flinders University, Adelaide, Australia.|South Australian Prostate Cancer Clinical Outcomes Collaborative, Adelaide, Australia.|Flinders University, Adelaide, Australia.
authors.forename: G
authors.initials: G
authors.lastname: Kichenadasse
authors.affiliation: Urology Unit, Repatriation General Hospital, SA Health, Adelaide, Australia.
authors.forename: S
authors.initials: S
authors.lastname: Plagakis
authors.affiliation: Flinders Centre for Innovation in Cancer, Flinders University, Adelaide, Australia.|South Australian Prostate Cancer Clinical Outcomes Collaborative, Adelaide, Australia.|University of Adelaide, Adelaide, Australia.|Urology Unit, Repatriation General Hospital, SA Health, Adelaide, Australia.
authors.forename: M E
authors.initials: ME
authors.lastname: O'Callaghan
authors.affiliation: South Australian Prostate Cancer Clinical Outcomes Collaborative, Adelaide, Australia.|Urology Unit, Repatriation General Hospital, SA Health, Adelaide, Australia.
authors.forename: T
authors.initials: T
authors.lastname: Kopsaftis
authors.affiliation: South Australian Prostate Cancer Clinical Outcomes Collaborative, Adelaide, Australia.|Urology Unit, Repatriation General Hospital, SA Health, Adelaide, Australia.
authors.forename: S
authors.initials: S
authors.lastname: Walsh
authors.affiliation: Flinders Centre for Innovation in Cancer, Flinders University, Adelaide, Australia.|South Australian Prostate Cancer Clinical Outcomes Collaborative, Adelaide, Australia.|Flinders University, Adelaide, Australia.|University of Adelaide, Adelaide, Australia.|Urology Unit, Repatriation General Hospital, SA Health, Adelaide, Australia.
authors.forename: D
authors.initials: D
authors.lastname: Foreman
mesh_terms: D000367:Age Factors; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood; D003131:Combined Modality Therapy; D018450:Disease Progression; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors; D013021:South Australia / Q000453:epidemiology; D015996:Survival Rate / Q000639:trends
chemical_list: D014408:Biomarkers, Tumor; D017430:Prostate-Specific Antigen
keywords: Biochemical recurrence; Mortality; Prostate cancer; Young men