title: Cause of Death in Korean Men with Prostate Cancer: an Analysis of Time Trends in a Nationwide Cohort.
abstract: Despite rapid increase in incidence of prostate cancer (PC) and PC survivors, there are few studies regarding competing causes of death and time trends in Asian population. We conducted a cohort study of 2% nationwide random sample of Korean National Health Insurance employees. A total of 873 patients who had received active treatments, including surgery, radiation therapy (RT) and androgen deprivation therapy (ADT), for newly diagnosed PC between 2003 and 2010 were included. The cause of death was categorized as PC, other cancers, cardiovascular disease, and other causes. During a median follow-up of 4.75 years, 29.4% (257/873) of the study population died. PC, other cancers, cardiovascular disease, and other causes were responsible for 46.3%, 35.4%, 6.6%, and 11.7%, respectively, of the decedents. Significant differences existed in the cause of death among treatment groups (P < 0.001). Only 20% and 9.5% of surgery and RT group died of PC, whereas 63.9% of ADT group died of PC. Other cancers were responsible for 56%, 74.6% and 17.8% of death in the surgery, RT and ADT group, respectively, while cardiovascular disease accounted for 4%, 6.3%, and 7.1% of death in the treatment groups. Analysis of time trends showed that PC-specific death tended to decrease (from 42.9% in 2003 to 23.1% in 2010), whereas non-PC causes tended to increase over the 8 years. Our results are valuable in overviewing causes of death and time trends in Korean PC patients, and planning future health policy for PC.
authors.affiliation: Department of Urology, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Korea.
authors.forename: Jinsung
authors.initials: J
authors.lastname: Park
authors.affiliation: Department of Family Medicine, Seoul National University Hospital, Seoul, Korea.
authors.forename: Beomseok
authors.initials: B
authors.lastname: Suh
authors.affiliation: Department of Family Medicine, Seoul National University Hospital, Seoul, Korea.
authors.forename: Dong Wook
authors.initials: DW
authors.lastname: Shin
authors.affiliation: Department of Urology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Jun Hyuk
authors.initials: JH
authors.lastname: Hong
authors.affiliation: Department of Urology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. hjahn@amc.seoul.kr.
authors.forename: Hanjong
authors.initials: H
authors.lastname: Ahn
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000401:mortality; D002423:Cause of Death / Q000639:trends*; D015331:Cohort Studies; D016208:Databases, Factual; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D056910:Republic of Korea; D012307:Risk Factors; D055815:Young Adult
keywords: Androgen Deprivation Therapy; Cause of Death; Mortality; Prostate Cancer; Prostatectomy; Radiation Therapy