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 (≤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 ≤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). Conclusion (s): 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.