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

AbstractBackground: The early diagnosis and right treatment strategy of localized prostate cancer (PCa) remains problematic. In order to characterize the survival of PCa patients, we compared patients’ all-cause and cancer-specific mortalities between pre- and post-PSA periods by stage in Finland.Material and methods: All PCa cases diagnosed in Finland between 1985 and 2013 (N = 91,329) were identified from the Finnish Cancer Registry (FCR). PCa stage at diagnosis was defined as localized, local node positive or metastasized. Standardized mortality ratios (SMRs), and relative and cause-specific survival were assessed by stage and introduction of PSA testing. The main limitation was the high proportion of men with unknown stage (28%).Results: A clear decreasing trend in the SMR of PCa patients was evident when pre- and post-PSA eras were compared: for localized PCa, the SMR was 1.43 (95%CI 1.38–1.48) in 1985–1989 and 0.98 (95%CI 0.95–1.01) in 2000–2004, and for metastasized PCa, the SMRs were 4.51 (95%CI 4...