Improved survival of patients with prostate cancer in northern Denmark, 1985-2004

In 2003 prostate cancer was the commonest non-cutaneous cancer among men. In general, the prognosis for men with prostate cancer is less favourable in Denmark than in neighbouring countries. We aimed to examine possible changes in the long-term survival of patients with prostate cancer in four counties in Denmark during the period 1985-2004.

From four Danish counties (population 1.6 million) we included all patients (n=8928) with an incident discharge diagnosis of prostate cancer, as recorded in regional hospital discharge registries. We determined age-stratified survival and mortality rates, and used Cox proportional hazards regression to assess changes over time while controlling for age.

The median age was 75 years (range 43-99 years). The number of patients increased during the four time periods, especially for those aged <70 years. The overall survival rate improved over time, in particular for the period 2001-04. One-year survival increased from 71% (1985-89) to 77% (2001-04). Overall 5-year survival was unchanged (26% and 28% for 1985-89 and 2001-04, respectively), whereas 5-year survival in patients aged <70 years improved from 35% in 1985-89 to 41% in 1995-99. Compared with the period 1985-89, the age-adjusted 1-year mortality rate ratio (MRR) was 0.79 (95% CI 0.70-0.89) (2000-04) and the age-adjusted 5-year MRR was 0.95 (95% CI 0.88-1.02 (1995-99).

The survival of prostate cancer patients has improved in Denmark over the time period 1985-2005, and this change was most pronounced in men aged <70 years. These results may suggest a benefit from increasing use of prostate-specific antigen testing leading to an earlier diagnosis of prostate cancer, in some cases with a lower tumour burden.