The analysis showed that when age groups are broken down into smaller sections, men 75 or older represented only 16 percent of the male population above age 50 and 26 percent of all cases of prostate cancer -- but 48 percent of cases of metastatic disease at diagnosis and 53 percent of all deaths. In general, higher grade cancer seemed to increase with age, the study said.
Researchers were looking for associations between age, metastasis and death because in clinical practice, Wu said, several URMC urologists observed that many otherwise healthy older men were presenting with very advanced disease at diagnosis, and reporting that they had never had a PSA test.
Indeed, older men have largely been excluded from prior clinical trials of the benefits of early detection, the study said. This is based on the idea that older men wouldn't benefit from early detection because of a shorter remaining life expectancy.
But Wu and colleagues contend that overall health, more than age, impacts life expectancy following a cancer diagnosis and that more studies are needed to identify ways to manage the disease in older patients.
"Due to a lot of natural variation in the biology of prostate cancer," Wu said, "the URMC study should stimulate the need to develop an algorithm to identify healthy, elderly men who might benefit from an earlier diagnosis."
|Contact: Leslie Orr|
University of Rochester Medical Center