Prostate cancer - survival statistics

Survival rates for prostate cancer have been improving for 30 years. However, interpretation of prostate cancer survival trends is difficult as the case-mix on which they are based is likely to have changed over time with earlier diagnoses following the advent of transurethral resection of the prostate (TURP) and, prostate specific antigen (PSA) testing.

The detection of a greater proportion of latent, earlier, slow-growing tumours in more recent time periods will have the effect of raising survival rates due to lead-time bias, that is, the difference in time between screen detection and clinical detection in the absence of screening. 1

Lead-time bias is estimated to be between 5-12 years, varying with a man's age at screening. 2,3 Data from the European Randomized Study of Prostate Cancer (ERSPC) estimated that for a single screening test, mean lead times of 12 years at age 55 and six years for a man aged 75. 3

There may also have been genuine improvements in survival due to more effective treatment, both for early, aggressive prostate cancers and for advanced cases. 4

One year survival rates for prostate cancer have improved from around 65% for patients diagnosed in 1971-75 to 93% in 2004-2006 (England only). Figure 3.1 shows the trend since the mid-1970s.5,6

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Five year survival rates since the mid-1970s are shown in Figure 3.2. Survival rates have risen from 31% for patients diagnosed in 1971-75 to 76% for men diagnosed in 2001-2006 (England only).5,7

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Ten-year survival rates for prostate cancer are show in Figure 3.3. Rates have increased from 21% in the mid-1970s to around 60% for men diagnosed in 1996-2000 (England only).5, 8, 14

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The same problems of interpretation apply to international comparisons of survival rates ( Figure 3.4). 9, 10 The 99% five-year survival rate recorded for white American men is likely to reflect the stage distribution of registrations in that country due to PSA testing. 11

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Survival from prostate cancer is strongly related to the stage of the disease at diagnosis. For disease which is confined to the prostate, five-year relative survival for patients in England in 1999-2002 is 90% or more, but if the disease is metastatic at presentation five-year relative survival is lower at around 30%. 12

For most cancers survival rates decrease with age of patient, but five-year relative survival rates for men diagnosed with prostate cancer in their 60s are higher than rates for either younger or older men ( Figure 3.5). 12, 13

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