Prostate cancer risk and outcomes in military men under 50 years of age

The ability to identify men at high risk for — and subsequently with — more aggressive forms of prostate cancer relatively early in their lives is obviously an important goal. Younger men tend to recover better from initial treatment for localized prostate cancer than their older peers.

Parker et al. have reviewed data from a 12,000+ patient, multi-institutional, military database to compare the clinicopathologic features and the survival outcomes for men < 50 years of age to those in other age groups stratified by race in order to better define prostate cancer in young men.

They started by identifying all patients of < 50 years of age in the database who were treated for prostate cancer between 1989 and 2009. They then stratified these patients by age group, race, and decade of treatment.

A careful analysis revealed the following data:

  • Only 4.5 percent of the total study sample (544/12,081) was < 50 years of age.
  • Significantly more African Americans diagnosed with prostate cancer were < 50 years of age compared with Caucasians (8.3 vs 3.3 percent, P <0.0001).
  • A positive family history was more evident among patients in the < 50 cohort compared to those of 50 years or more (36.1 vs 22.0 percent, P <0.0001).
  • The two racial subgroups for men < 50 years of age (i.e., African Americans and Caucasians) both had improved clinicpathologic features compared to those of other age quartiles.
  • The < 50 cohort had a lower incidence of biochemical recurrence and greater overall survival that those of other age quartiles.

The authors conclude that in this cohort of males < 50 years of age, “Race and family history appear to play a significant role” in the incidence of prostate cancer.”

They further comment that younger age at diagnosis was indeed associated with more favorable outcomes and that population-based testing at younger ages could potentially lead to improved survival for high-risk groups.

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