Vinayak Muralidhar1, David R Ziehr2, Brandon A Mahal2, Yu-Wei Chen3, Michelle D Nezolosky4, Vidya B Viswanathan4, Toni K Choueiri5, Christopher J Sweeney5, Quoc-Dien Trinh6, Paul L Nguyen7. 1. Harvard-MIT Division of Health Sciences and Technology, Harvard Medical School, Boston, MA. 2. Harvard Medical School, Boston, MA. 3. Harvard T. H. Chan School of Public Health, Boston, MA. 4. Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, MA. 5. Department of Medical Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Harvard Medical School, Boston, MA. 6. Department of Urology, Brigham and Women's Hospital, Boston, MA. 7. Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, MA. Electronic address: pnguyen@LROC.harvard.edu.
Abstract
INTRODUCTION: In order to help inform the discussion about the risks versus benefits of prostate cancer screening among older men, we determined whether advanced age is associated with a higher probability of harboring high-grade or high-risk disease. PATIENTS AND METHODS: The Surveillance, Epidemiology, and End Results (SEER) database was used to identify 383,039 men diagnosed with prostate cancer in 2004-2011. The percentage of patients diagnosed with low-, intermediate-, or high-risk disease or a Gleason score of 6, 7, or 8 to 10 was calculated by age range. As a secondary analysis, we examined whether this relationship was different in 2010-2011 versus 2007-2008 (before and after the 2009 publication of screening trials). RESULTS: The probability of Gleason score 8 to 10 or high-risk disease increased significantly with increasing age. The percentage of Gleason score 8 to 10 disease among men ages 50 to 54, 70 to 74, and 80 to 84 years was 8.9%, 16.2%, and 28.5%, respectively, and the percentage of high-risk disease was 14.3%, 22.4%, and 38.7% (P < .001). There were similar relationships among men with stage T1c disease. In addition, older men experienced a significant increase in the relative probability of high-risk or high-grade disease from 2007-2008 to 2010-2011. CONCLUSION: In this large US-based cohort, older men had a much higher probability of high-grade or high-risk prostate cancer. Physicians and patients should take into account the higher risk of more aggressive or advanced disease in older men when discussing the risks and benefits of prostate-specific antigen screening with healthy older men with a substantial life expectancy.
INTRODUCTION: In order to help inform the discussion about the risks versus benefits of prostate cancer screening among older men, we determined whether advanced age is associated with a higher probability of harboring high-grade or high-risk disease. PATIENTS AND METHODS: The Surveillance, Epidemiology, and End Results (SEER) database was used to identify 383,039 men diagnosed with prostate cancer in 2004-2011. The percentage of patients diagnosed with low-, intermediate-, or high-risk disease or a Gleason score of 6, 7, or 8 to 10 was calculated by age range. As a secondary analysis, we examined whether this relationship was different in 2010-2011 versus 2007-2008 (before and after the 2009 publication of screening trials). RESULTS: The probability of Gleason score 8 to 10 or high-risk disease increased significantly with increasing age. The percentage of Gleason score 8 to 10 disease among men ages 50 to 54, 70 to 74, and 80 to 84 years was 8.9%, 16.2%, and 28.5%, respectively, and the percentage of high-risk disease was 14.3%, 22.4%, and 38.7% (P < .001). There were similar relationships among men with stage T1c disease. In addition, older men experienced a significant increase in the relative probability of high-risk or high-grade disease from 2007-2008 to 2010-2011. CONCLUSION: In this large US-based cohort, older men had a much higher probability of high-grade or high-risk prostate cancer. Physicians and patients should take into account the higher risk of more aggressive or advanced disease in older men when discussing the risks and benefits of prostate-specific antigen screening with healthy older men with a substantial life expectancy.
Authors: Erin K Tagai; Suzanne M Miller; Alexander Kutikov; Michael A Diefenbach; Ronak A Gor; Tahseen Al-Saleem; David Y T Chen; Sara Fleszar; Gem Roy Journal: J Cancer Educ Date: 2019-06 Impact factor: 2.037
Authors: Minh-Phuong Huynh-Le; Tor Åge Myklebust; Christine H Feng; Roshan Karunamuni; Tom Børge Johannesen; Anders M Dale; Ole A Andreassen; Tyler M Seibert Journal: Cancer Date: 2020-01-03 Impact factor: 6.860
Authors: Minh-Phuong Huynh-Le; Chun Chieh Fan; Roshan Karunamuni; Eleanor I Walsh; Emma L Turner; J Athene Lane; Richard M Martin; David E Neal; Jenny L Donovan; Freddie C Hamdy; J Kellogg Parsons; Rosalind A Eeles; Douglas F Easton; Zsofia Kote-Jarai; Ali Amin Al Olama; Sara Benlloch Garcia; Kenneth Muir; Henrik Grönberg; Fredrik Wiklund; Markus Aly; Johanna Schleutker; Csilla Sipeky; Teuvo Lj Tammela; Børge Grønne Nordestgaard; Timothy J Key; Ruth C Travis; Paul D P Pharoah; Nora Pashayan; Kay-Tee Khaw; Stephen N Thibodeau; Shannon K McDonnell; Daniel J Schaid; Christiane Maier; Walther Vogel; Manuel Luedeke; Kathleen Herkommer; Adam S Kibel; Cezary Cybulski; Dominika Wokolorczyk; Wojciech Kluzniak; Lisa A Cannon-Albright; Hermann Brenner; Ben Schöttker; Bernd Holleczek; Jong Y Park; Thomas A Sellers; Hui-Yi Lin; Chavdar Kroumov Slavov; Radka P Kaneva; Vanio I Mitev; Jyotsna Batra; Judith A Clements; Amanda B Spurdle; Manuel R Teixeira; Paula Paulo; Sofia Maia; Hardev Pandha; Agnieszka Michael; Ian G Mills; Ole A Andreassen; Anders M Dale; Tyler M Seibert Journal: Cancer Epidemiol Biomarkers Prev Date: 2020-06-24 Impact factor: 4.254
Authors: Michael D Gross; Bashir Al Hussein Al Awamlh; Jonathan E Shoag; Elizabeth Mauer; Samprit Banerjee; Daniel J Margolis; Juan M Mosquera; Ann S Hamilton; Maria J Schumura; Jim C Hu Journal: BMJ Surg Interv Health Technol Date: 2019-08-23