Defining Long-term Prostate Cancer Treatment Patterns and Adverse Urologic Events: A Methodological Framework and...

Area of Science:

• Urology
• Oncology
• Population Health

Background:

• Prostate cancer (PCa) has high survival rates but limited data exists on long-term urologic morbidity.
• Existing datasets often exclude younger populations, hindering comprehensive survivorship research.

Purpose of the Study:

• To establish a framework using the Utah Population Database (UPDB) for identifying PCa patients.
• To characterize PCa treatment patterns and quantify long-term urologic adverse events (UAEs).

Main Methods:

• Retrospective matched cohort study of men aged 18-85 with localized PCa (1996-2023) in the UPDB.
• Age- and sex-matched controls (2:1 ratio) were selected; exclusions applied for prior UAE, metastatic disease, or missing data.
• UAEs were categorized as low- or high-grade, with temporal analyses at 1, 5, 10, 15, and 20 years post-diagnosis.

Main Results:

• 36,482 PCa cases and 69,722 controls were analyzed with a median follow-up of 8.0 and 7.8 years, respectively.
• By 20 years post-diagnosis, 50% of PCa patients experienced low-grade UAEs (vs. 39% controls) and 15.1% experienced high-grade UAEs (vs. 6.7% controls).
• PCa patients had a 2.6-fold higher risk of secondary urologic malignancy compared to controls.

Conclusions:

• The UPDB framework facilitates long-term evaluation of treatment-related morbidity in diverse PCa patient populations, including those under 65.
• This approach enhances survivorship research accuracy and can inform predictive modeling for patient counseling and treatment planning.