Background: Previous Commission on Cancer studies on prostate cancer have examined time trends in disease stage, treatment patterns, and survival. The most current National Cancer Data Base data for prostate cancer are reviewed in this report.
Methods: Two Calls for Data have yielded a total of 85,813 prostate cancer reports from hospital registries across the country.
Results: The proportion of early stage, curable prostate cancers diagnosed in the United States has increased. In 1990, African-American patients were more likely to be diagnosed with metastatic prostate cancer than were non-Hispanic whites. The proportion of patients treated by prostatectomy increased between 1974 and 1990. Consistent with the pattern of more advanced disease at diagnosis, African-American patients were less likely to have received prostatectomy or radiation treatment and more likely to have received only hormonal treatment. Prostate cancer survival was associated strongly with disease stage. African-American men had a lower 5-year survival than did non-Hispanic white men.
Conclusions: This information provides national points of reference against which individual hospital performance can be compared and should be particularly helpful to cancer committees, tumor boards, and cancer registrars for the monitoring and evaluation of prostate cancer management in hospital cancer programs. Not all segments of the population-at-risk are benefiting from earlier detection of prostate cancer. Improvements in early detection have important consequences for treatment patterns, allowing the increased use of curative surgical or radiotherapeutic treatment.