Reduced incidence of bony metastasis at initial prostate cancer diagnosis: Data from CaPSURE™

Charles J. Ryan, Eric P. Elkin, Eric J. Small, Janeen Duchane, Peter Carroll

Research output: Contribution to journalArticlepeer-review

50 Scopus citations

Abstract

Purpose: Despite stage migration as a result of screening, many individuals are diagnosed each year with metastatic (M+), as opposed to localized (M0), prostate cancer. This study describes features that characterize patients with M+ compared to those diagnosed with M0 disease. Materials and Methods: Patients enrolled in the Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE™), a national, longitudinal registry of men with prostate cancer, formed the basis of this study. The prevalence, and changes with time, of patients with M+ and M0 cancer by clinical and sociodemographic characteristics were examined. Results: Of 10,113 patients diagnosed between 1990 and 2003, 266 (2.6%) had M+ disease at diagnosis. From 1990 to 1997, 4.2% of 4020 total patients had M+ versus 1.6% of 6093 total patients diagnosed between 1998 and 2003 (odds ratio 0.34; 95% confidence interval 0.24-0.48; P < 0.0001). In univariate analysis, advanced age, higher prostate-specific antigen, Gleason grade, black race, lower income, and lower educational level were associated with M+ versus M0 disease (P < 0.01). However, in multivariate analysis, only higher serum prostate-specific antigen and higher Gleason grade, and not the sociodemographic variables, remained associated with M+ disease (P < 0.01). Patients with M+ diagnosed between 1998 and 2003 are more likely to harbor high-grade (Gleason ≥8) primary tumors (62% vs. 45%, P = 0.02) than those diagnosed between 1990 and1997. No changes in age, race, education, insurance status, or income were observed in the early versus late era. Conclusions: These findings show a reduction in the incidence of metastatic disease at initial prostate cancer diagnosis. Furthermore, biologic, rather than socioeconomic, factors are associated with this type of disease presentation.

Original languageEnglish (US)
Pages (from-to)396-402
Number of pages7
JournalUrologic Oncology: Seminars and Original Investigations
Volume24
Issue number5
DOIs
StatePublished - Sep 1 2006
Externally publishedYes

Keywords

  • Bone metastasis
  • Prostate cancer epidemiology
  • Prostate-specific antigen screening

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