The study is particularly relevant in light of the recent controversy about prostate cancer screening. Earlier this month a government health panel said that healthy men age 50 and older should no longer be routinely tested for prostate cancer because the screening test in its current form does not save lives and sometimes leads to needless suffering and overtreatment. Patient advocates and many clinicians disagreed with the finding.
Although the Rochester study does not address screening directly it does raise questions about the benefits of earlier detection among the elderly.
“Especially for older people, the belief is that if they are diagnosed with prostate cancer it will grow slowly and they will die of something else,” said lead author Guan Wu, M.D., Ph.D., assistant professor of Urology and of Pathology and Laboratory Medicine at the University of Rochester Medical Center.
“We hope our study will raise awareness of the fact that older men are actually dying at high rates from prostate cancer,” he said. “With an aging population it is important to understand this, as doctors and patients will be embarking on more discussions about the pros and cons of treatment.”
Wu and colleagues studied the largest national cohort of cancer patients, called the Surveillance, Epidemiology, and End Results (SEER) database. They analyzed 464,918 records of men diagnosed with prostate cancer between 1998 and 2007, known as the “PSA era” because of a strong inclination to recommend the PSA test during that time.
(The prostate-specific antigen or PSA is a protein produced by the prostate gland, which can be measured in the blood. An elevated PSA is associated with cancer and other noncancerous prostate conditions.)
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.”
The research was funded by the Ashley Family Foundation. Co-investigators are: Edward M. Messing, M.D., chair of the URMC Department of Urology; Emil N. Scosyrev, Ph.D., assistant professor of Urology; Supriya G. Mohile, M.D., M.S., assistant professor of Medicine in Hematology/Oncology with a special interest in geriatrics at the URMC’s James P. Wilmot Cancer Center; and Dragan Golijanin, M.D., a former URMC faculty member in Urology.For Media Inquiries:
Leslie Orr | EurekAlert!
New malaria analysis method reveals disease severity in minutes
14.08.2017 | University of British Columbia
New type of blood cells work as indicators of autoimmunity
14.08.2017 | Instituto de Medicina Molecular
Whether you call it effervescent, fizzy, or sparkling, carbonated water is making a comeback as a beverage. Aside from quenching thirst, researchers at the University of Illinois at Urbana-Champaign have discovered a new use for these "bubbly" concoctions that will have major impact on the manufacturer of the world's thinnest, flattest, and one most useful materials -- graphene.
As graphene's popularity grows as an advanced "wonder" material, the speed and quality at which it can be manufactured will be paramount. With that in mind,...
Physicists at the University of Bonn have managed to create optical hollows and more complex patterns into which the light of a Bose-Einstein condensate flows. The creation of such highly low-loss structures for light is a prerequisite for complex light circuits, such as for quantum information processing for a new generation of computers. The researchers are now presenting their results in the journal Nature Photonics.
Light particles (photons) occur as tiny, indivisible portions. Many thousands of these light portions can be merged to form a single super-photon if they are...
For the first time, scientists have shown that circular RNA is linked to brain function. When a RNA molecule called Cdr1as was deleted from the genome of mice, the animals had problems filtering out unnecessary information – like patients suffering from neuropsychiatric disorders.
While hundreds of circular RNAs (circRNAs) are abundant in mammalian brains, one big question has remained unanswered: What are they actually good for? In the...
An experimental small satellite has successfully collected and delivered data on a key measurement for predicting changes in Earth's climate.
The Radiometer Assessment using Vertically Aligned Nanotubes (RAVAN) CubeSat was launched into low-Earth orbit on Nov. 11, 2016, in order to test new...
A study led by scientists of the Max Planck Institute for the Structure and Dynamics of Matter (MPSD) at the Center for Free-Electron Laser Science in Hamburg presents evidence of the coexistence of superconductivity and “charge-density-waves” in compounds of the poorly-studied family of bismuthates. This observation opens up new perspectives for a deeper understanding of the phenomenon of high-temperature superconductivity, a topic which is at the core of condensed matter research since more than 30 years. The paper by Nicoletti et al has been published in the PNAS.
Since the beginning of the 20th century, superconductivity had been observed in some metals at temperatures only a few degrees above the absolute zero (minus...
16.08.2017 | Event News
04.08.2017 | Event News
26.07.2017 | Event News
18.08.2017 | Life Sciences
18.08.2017 | Physics and Astronomy
18.08.2017 | Materials Sciences