Background
A Dutch population-based study showed that older men with intermediate- or high-risk prostate cancer (PCa) were treated with curative intent less often than younger patients. To assess generalisability, we investigated treatment patterns in men with all PCa stages aged <70 years versus ≥70 years in Sweden and Belgium.
Patients and methods
Men diagnosed with PCa between 2005 and 2015 were identified from the Prostate Cancer data Base Sweden and from two centres in Ghent and Leuven, Belgium. Multivariable logistic regression, adjusting for PCa stage, prostate-specific antigen, Gleason score, and Charlson comorbidity index, assessed the impact of age (</≥70 years) on curative treatment in intermediate- and high-risk PCa. Ten-year relative survival was calculated for four age groups per country to assess excess mortality versus the general population.
Results
In total, 58 092 men <70 years and 50 886 men ≥70 years were diagnosed in Sweden, Leuven, and Ghent. In both countries, patients aged ≥70 years were less likely to receive curative treatments for intermediate- and high-risk PCa versus those <70 years. In Sweden, 10-year relative survival was roughly 90-95% across all four age groups. In Leuven, survival was 100% for all except those ≥80 years, where it was 90%.
Conclusion
Men aged ≥70 years were treated with curative intent less frequently for intermediate- and high-risk PCa compared with younger men. The differing relative survival rates reflect heterogeneity in PCa stage distribution between countries. Age should be considered when planning curative treatments, but it should not be the sole determinant of therapeutic decisions.
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