Early‐onset prostate cancer is associated with increased risks of disease progression and cancer‐specific mortality

• Published in: The Prostate Vol. 81; no. 2; pp. 118 - 126
• Main Authors: Shih, Hung‐Jen, Fang, Su‐Chen, An, Lu, Shao, Yu‐Hsuan J.
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.02.2021
• Subjects: Age; Cancer therapies; Diagnosis; early‐onset; Metastases; Metastasis; Mortality; Patients; Prostate cancer; prostate cancer‐specific mortality; prostate cancer-specific mortality; prostate cancer; early-onset
• ISSN: 0270-4137; 1097-0045; 1097-0045
• DOI: 10.1002/pros.24087

Objective Prostate cancer (PCa) incidence has stabilized but not in patients at a young age. We assessed patient characteristics and disease progression in early‐onset PCa. Methods A retrospective cohort of 28,039 newly diagnosed PCa patients aged ≥35 years was constructed using the Taiwan Cancer Registry in 2008–2016. Patients were categorized by age at diagnosis (≤54, 55–59, 60–69, 70–74, and ≥75 years). The clinical stage at diagnosis, Gleason score, prostate‐specific antigen level at diagnosis, Charlson's comorbidity index, and primary and secondary treatments for PCa were included in the analysis. All‐cause mortality and prostate cancer‐specific mortality (PCSM) were reported. Hazard ratios (HRs) and 95% confidence intervals (CIs) estimating the risks of death and of receiving secondary cancer treatment were generated by Cox hazard models. Results In patients aged ≤54, 55–59, and 60–69 years, about 60% of them in each group were classified into the high‐risk, very high‐risk, or metastatic group. However, young patients ≤54 years had a higher risk of PCSM than patients aged 60–69 years (HR = 1.22; 95% CI = 1.10–1.49). This trend of an increased risk in PCSM remained for high‐risk, very high‐risk, or metastatic patients (HR = 1.24; 95% CI = 1.01–1.51), but not in low‐ or intermediate‐risk patients. Besides, young patients diagnosed with high‐risk diseases had the highest risk of receiving secondary cancer treatment within 180 days after completing primary treatment among all age groups (HR = 1.32; 95% CI = 1.07–1.63). Conclusions PCa arising in young patients ≤54 years of age, especially those with a high risk or metastatic form, might be more aggressive than that in other age groups.