Stage-specific mortality and survival trends of prostate cancer patients in Finland before and after introduction of PSA

Figures & data

Figure 1. The numbers of newly diagnosed prostate cancer cases by calendar period and stage. All stages (black circles), localized disease (circles), metastasized (triangles), unknown (squares).

Table 1. Basic characteristics of the study population.

		PCa diagnosis		Deaths in 5-year follow-up		Deaths in 10-year follow-up
		N	Percent	PCa deaths	Other deaths	PCa deaths	Other deaths
Total	–	91,329	100.0	13,051	14,552	17,244	22,460
Stage	Localized	47,001	51.5	2379	6735	4058	11,228
	Unknown	25,391	27.8	2992	5206	4207	7653
	Metastasized	18,153	19.9	7505	2527	8714	3448
	Local node positive	784	0.8	175	84	265	131
Year of diagnosis	1985–1989	6227	6.8	2222	1457	2853	2276
	1990–1994	8579	9.4	2665	2054	3506	3192
	1995–1999	14,130	15.5	2817	3052	3944	5037
	2000–2004	20,365	22.3	2420	3515	3596	6360
	2005–2009	22,868	25.0	2117	3394	2535^a	4515^a
	2010–2013	19,160	21.0	810^a	1080^a
Age at diagnosis (median 71.3 y, IQR = 64.7–77.8)	>80	16,178	17.7	3816	5514	4480	7445
	70–79	34,683	38.0	5189	6333	7090	10,339
	60–69	29,613	32.4	3073	2308	4370	3987
	50–59	10,063	11.0	863	380	1171	664
	<50	792	0.9	110	17	133	25
Pre-PSA (1985–1994)	Localized	6637	61.4	1066	1767	1722	2973
	Metastasized	4172	38.6	2773	576	3121	759
Post-PSA (1995–2004)	Localized	16,831	73.3	891	2745	1730	5320
	Metastasized	6137	26.7	2754	950	3455	1542

IQR: interquartile range.

^a Not all patients have complete follow-up.

Table 2. SMR by stage and year of diagnosis. Periods 1985–1994 represent the pre-PSA era and periods 1995–2004 the post-PSA era. Follow-up is limited to 10 years.

Stage	Year of diagnosis	Observed numberof deaths	Expected numberof deaths	Person-years	SMR (CI: 95%)
	All	39,599	25,526.5	465,436	1.55 (1.54–1.57)
All stages combined	1985–1989	5120	2460.8	29,070.6	2.08 (2.02–2.14)
	1990–1994	6687	3444.6	43,051.2	1.94 (1.90–1.99)
	1995–1999	8951	5590.9	87,213.5	1.60 (1.57–1.63)
	2000–2004	9912	7340.4	145,907.0	1.35 (1.32–1.38)
	2005–2009	7040	5354.5	124,777.0	^b1.31 (1.28–1.35)
					^ap value <.001
Localized	1985–1989	2103	1399.1	16,562.2	1.50 (1.44–1.57)
	1990–1994	2580	1825.2	23,535.8	1.41 (1.36–1.47)
	1995–1999	3285	2818.7	46,753.2	1.17 (1.13–1.21)
	2000–2004	3729	3813.9	84,809.9	0.98 (0.95–1.01)
	2005–2009	2986	3171.6	81,512.7	^b0.94 (0.91–0.98)
					^ap value <.001
Metastasized	1985–1989	1759	390.3	4971.2	4.51 (4.30–4.72)
	1990–1994	2118	555.8	7375.7	3.81 (3.65–3.98)
	1995–1999	2374	816.8	12,661.0	2.91 (2.79–3.03)
	2000–2004	2610	868.2	15,091.6	3.01 (2.89–3.12)
	2005–2009	2512	1054.0	21,546.1	^b2.38 (2.29–2.48)
					^ap value <.001
Unknown	1985–1989	1182	639.0	7048.0	1.85 (1.75–1.96)
	1990–1994	1888	1023.2	11,398.2	1.85 (1.76–1.93)
	1995–1999	3182	1916.1	26,715.3	1.66 (1.60–1.72)
	2000–2004	3500	2624.8	44,932.4	1.33 (1.29–1.38)
	2005–2009	1513	1106.7	21,146.2	^b1.37 (1.30–1.44)
					^ap value <.001

^a p Value tests for significance of the calendar trend.

^b Not all patients have complete follow-up.

Figure 2. Relative survival (Relative) and cause-specific survival with respect to PCa (Cancer) and other causes than PCa (Other) of localized and metastasized prostate cancers in pre- (1985–1994) and post- (1995–2004) PSA-testing eras.

Table 3. Survival estimates for Figure 2.

Stage	Survival type	PSA era	5-year survival %	10-year survival %
Localized	Relative	Pre	84.7 (81.6–88.0)	66.1 (61.3–71.2)
		Post	99.5 (97.8–101)	94.6 (91.4–97.8)
	Cancer	Pre	81.4 (79.5–83.4)	63.6 (60.8–66.5)
		Post	93.1 (92.3–93.9)	84.2 (82.9–85.5)
	Other causes	Pre	72.6 (70.7–74.6)	47.6 (45.3–49.9)
		Post	80.5 (79.4–81.6)	60.3 (59.0–61.6)
Metastasized	Relative	Pre	29.5 (26.3–33.0)	16.9 (13.6–21.1)
		Post	53.9 (50.9–57.1)	34.7 (31.1–38.7)
	Cancer	Pre	27.5 (24.9–30.3)	14.1 (12.0–16.7)
		Post	51.8 (49.4–54.3)	34.1 (31.5–36.8)
	Other causes	Pre	74.7 (71.2–78.3)	51.8 (46.4–57.7)
		Post	77.8 (75.6–80.1)	53.5 (50.3–56.8)

Relative survival (Relative) and cause-specific survival with respect to PCa (Cancer) and other causes than PCa (Other causes) of localized and metastasized prostate cancers in pre- (1985–1994) and post- (1995–2004). PSA-testing eras.