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Characteristics of incidental prostate cancer in the United States

Prostate Cancer and Prostatic Diseases (2023)Cite this article

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Abstract

Background

Data regarding North-American incidental (cT1a/b) prostate cancer (PCa) patients is scarce. To address this, incidental PCa characteristics (age, PSA values at diagnosis, Gleason score [GS]), subsequent treatment and cancer-specific survival (CSS) rates were explored.

Methods

Incidental PCa patients were identified within the Surveillance, Epidemiology, and End Results (SEER) database (2004-2015). Descriptive statistics, annual percentage changes (EAPC), Kaplan-Meier estimates, as well as Cox regression models were used. Bootstrapping technique was used to generate 95% confidence intervals for CSS at 6 years.

Results

Of all 344,031 newly diagnosed non metastatic PCa patients, 5155 harbored incidental PCa. Annual rates of incidental PCa increased from 1.9% (2004) to 2.5 % (2015; p = 0.02). PSA values at diagnosis were 0–4 ng/ml in 48% vs. 4–10 ng/ml in 31% vs. > 10 ng/ml in 21%. Of all incidental PCa patients, 64% harbored GS 6 vs. 25% GS 7 vs. 11% GS ≥ 8. Of all incidental PCa patients, 47% were aged < 70, 35% were between 70 and 79 and 18% were ≥ 80 years. Subsequently, 71% underwent no local treatment (NLT) vs. 16% radical prostatectomy (RP) vs. 14% radiotherapy (RT). Proportions of patients with NLT increased from 65 to 81% (p = 0.0001) over the study period (2004–2015). CSS at six years ranged from 58% in GS ≥ 8 patients with NLT to 100% in patients who harbored GS 6 and underwent either RP or RT.

Conclusion

Incidental PCa in the United States is rare. Most incidental PCa patients are diagnosed in men aged less than 80 years of age. The majority of incidental PCa patients undergo NLT and enjoy excellent CSS.

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Fig. 1: Estimated annual percentage change in rates of incidental PCa.
Fig. 2: Estimated annual percentage change in treatment.

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Data availability

All data generated for this analysis were from the Surveillance, Epidemiology, and End Results Research Plus (SEER) database. The code for the analyses will be made available upon request.

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Authors and Affiliations

  1. Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC, Canada

    Lukas Scheipner, Reha-Baris Incesu, Simone Morra, Andrea Baudo, Anis Assad, Letizia Maria Ippolita Jannello, Carolin Siech, Mario de Angelis, Francesco Barletta, Zhe Tian, Fred Saad & Pierre I. Karakiewicz

  2. Department of Urology, Medical University of Graz, Graz, Austria

    Lukas Scheipner & Sascha Ahyai

  3. Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany

    Reha-Baris Incesu & Derya Tilki

  4. Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131, Naples, Italy

    Simone Morra

  5. Department of Urology, IRCCS Policlinico San Donato, Milan, Italy

    Andrea Baudo & Nicola Longo

  6. Department of Urology, IEO European Institute of Oncology, IRCCS, Via Ripamonti 435, Milan, Italy

    Letizia Maria Ippolita Jannello, Luca Carmignani & Ottavio De Cobelli

  7. Università degli Studi di Milano, Milan, Italy

    Letizia Maria Ippolita Jannello & Ottavio De Cobelli

  8. Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, Frankfurt am Main, Germany

    Carolin Siech & Felix K. H. Chun

  9. Division of Experimental Oncology/Unit of Urology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy

    Mario de Angelis, Francesco Barletta & Alberto Briganti

  10. Medical University of Vienna, Vienna, Austria

    Shahrokh F. Shariat

  11. Department of Urology, Weill Cornell Medical College, New York, NY, USA

    Shahrokh F. Shariat

  12. Department of Urology, University of Texas Southwestern, Dallas, TX, USA

    Shahrokh F. Shariat

  13. Hourani Center for Applied Scientific Research, Al-Ahliyya Amman University, Amman, Jordan

    Shahrokh F. Shariat

  14. Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany

    Derya Tilki

  15. Department of Urology, Koc University Hospital, Istanbul, Turkey

    Derya Tilki

  16. Department of Urology, IRCCS Ospedale Galeazzi - Sant’Ambrogio, Milan, Italy

    Luca Carmignani

  17. Department of Oncology and Haemato-Oncology, Università degli Studi di Milano, 20122, Milan, Italy

    Ottavio De Cobelli

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  1. Lukas Scheipner
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  2. Reha-Baris Incesu
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  10. Zhe Tian
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  14. Felix K. H. Chun
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  16. Nicola Longo
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  18. Ottavio De Cobelli
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  19. Sascha Ahyai
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  20. Pierre I. Karakiewicz
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Contributions

Concept and design: LS, FB, PIK. Data management and analysis: R-BI, SM, AB, AA, LMIJ, CS, MdA, ZT. Manuscript writing: LS, PIK, SA. Interpretation and supervision: FS, SFS, AB, FKHC, DT, NL, LC, ODC. Final approval of manuscript: all authors.

Corresponding author

Correspondence to Lukas Scheipner.

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Competing interests

The authors declare no competing interests.

Ethics approval

All analyses and their reporting followed the SEER reporting guidelines. Due to the anonymously coded design of the SEER database, study-specific Institutional Review Board ethics approval was not required.

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Scheipner, L., Incesu, RB., Morra, S. et al. Characteristics of incidental prostate cancer in the United States. Prostate Cancer Prostatic Dis (2023). https://doi.org/10.1038/s41391-023-00742-7

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