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Years of Life Lost in Incidental Prostate Cancer
Fabian Falkenbach1,2,3, Mattia Longoni1,4,5, Andrea Marmiroli1,6,7
1Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, Quebec, Canada.
The Prostate
|July 8, 2026
Summary
Incidental prostate cancer (IPCa) can shorten lifespan, particularly for men with higher Gleason scores or advanced stage who don't receive active treatment. Low-risk IPCa patients can safely forgo active treatment without impacting premature death.
Area of Science:
- Oncology
- Urology
- Public Health
Background:
- The impact of incidental prostate cancer (IPCa) on survival is not well understood.
- Quantifying years of life lost (YLL) due to IPCa is crucial for understanding its public health burden.
Purpose of the Study:
- To determine the average years of life lost (YLL) in patients diagnosed with incidental prostate cancer (IPCa).
- To analyze how factors like Gleason sum, clinical stage, and active treatment influence YLL in IPCa patients.
Main Methods:
- Utilized the SEER database (2004-2021) to identify IPCa patients aged 45-75.
- Stratified patients by Gleason sum, clinical stage, and treatment status (radical prostatectomy or radiotherapy).
- Employed Monte Carlo simulations and Kaplan-Meier analysis to compare YLL between IPCa patients and population controls.
Main Results:
- IPCa patients experienced a survival disadvantage of 0.23 YLL compared to controls.
- Patients not receiving active treatment had a greater YLL (0.25) than those receiving active treatment (0.18).
- Significant YLL disadvantages were observed in untreated patients with high Gleason scores (8-10) and advanced clinical stage (T1b).
Conclusions:
- Active treatment is recommended for IPCa patients with advanced Gleason sum or clinical stage to mitigate substantial YLL.
- Omitting active treatment in low-risk IPCa patients (Gleason ≤7 and/or T1a) did not result in a YLL disadvantage.
- These findings highlight the importance of tailored treatment strategies for incidental prostate cancer based on risk stratification.
