Competitive risk of specific mortality in prostate cancer patients in Espírito Santo, Brazil: a retrospective cohort study

Keywords

prostate cancer-specific mortality - prostatic neoplasms - competing risk - fine-gray model - cancer epidemiology

Introduction: Prostate cancer is one of the most common cancers in the world, being a major cause of premature death in men, and the survival period of this neoplasm has been significantly prolonged worldwide. Here we aim to analyze the risk factors for specific mortality in patients diagnosed with prostate cancer, in a state in southeastern Brazil.

Methods: A retrospective cohort study was conducted, using a database of 10,556 patients with prostate cancer diagnosed between 2000 and 2016. Data was extracted from a cancer records database linked to the Mortality Information System of a Brazilian state. The cases were divided into deaths from prostate cancer, deaths from other causes and alive, and we followed them for at least 5 years. Multivariate analysis in the presence of competing risks was performed using the Fine-Gray proportional model.

Results: At the end of 2022, the cohort comprised 6,388 individuals still alive, with 1,936 experiencing specific deaths due to prostate cancer and 2,232 deaths resulting from other causes. Regarding the competing risks, age emerged as a specific risk factor for death. For each 10-year increase at the time of diagnosis, patients exhibited an almost 10% higher risk of death from prostate cancer (HR=1.098; 95%CI=1.024-1.176). Patients faced a heightened risk of death from prostate cancer in the presence of distant metastasis (HR=5.315; 95%CI=4.676-6.041). Conversely, there was a decrease in the risk of prostate cancer-specific mortality among patients with a medium or higher level of education (HR=0.767; 95%CI=0.629-0.935) compared to illiterate patients. Additionally, patients who underwent surgery (HR=0.382; 95%CI=0.309-0.471) and radiotherapy (HR=0.477; 95%CI=0.396-0.575) experienced a reduced risk of death from prostate cancer.

Conclusion: In conclusion, we found that age, educational level, presence of distant metastasis, surgery, radiotherapy, and hormone therapy were associated with the risk of specific mortality in patients with prostate cancer.

Corresponding author: Luís Carlos Lopes-Júnior (e-mail: [e-mail]).

 

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No conflict of interest has been declared by the author(s).

Publication History

Article published online:
06 May 2025