As with most cancers, survival for prostate cancer is improving. 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 TURP and 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). Lead-time bias for prostate cancer is estimated to be between five and 12 years, varying with a man's age at screening.[2,3] Data from the European Randomized Study of Prostate Cancer estimates that for a single screening test, mean lead times are 12 years at age 55 and six years at age 75. Some of the increase may also be attributed to genuine improvements in survival due to more effective treatment, for both early, aggressive prostate cancers and advanced cases.
Prostate Cancer (C61), Age-Standardised One-Year Net Survival, Men (Aged 15-99), England and Wales, 1971-2011
Survival at five years is strongly associated with the amount of PSA testing in the population, though improvements in treatment are likely to have had some impact. Five-year age-standardised net survival for prostate cancer has increased from 37% during 1971-1972 to a predicted survival of 85% during 2010-2011 in England and Wales – an absolute survival difference of 48 percentage points.
Prostate Cancer (C61), Age-Standardised Five-Year Net Survival, Men (Aged 15-99), England and Wales, 1971-2011
Ten-year survival has increased by an even greater amount than one- and five-year survival since the early 1970s. This is again generally attributable to PSA testing, as well as the success of treatment. Ten-year age-standardised net survival for prostate cancer has increased from 25% during 1971-1972 to a predicted survival of 84% during 2010-2011 in England and Wales – an absolute survival difference of 59 percentage points. Overall, more than 8 in 10 men diagnosed with prostate cancer today are predicted to survive their disease for at least ten years.
Prostate Cancer (C61), Age-Standardised Ten-Year Net Survival, Men (Aged 15-99), England and Wales, 1971-2011
- Parker C, Muston D, Melia J, et al. A model of the natural history of screen-detected prostate cancer, and the effect of radical treatment on overall survival. Br J Cancer 2006;94(10):1361-8.
- Pashayan N, Powles J, Brown C, et al. Excess cases of prostate cancer and estimated overdiagnosis associated with PSA testing in East Anglia. Br J Cancer 2006;95(3):401-5.
- Draisma G, Boer R, Otto SJ, et al. Lead times and overdetection due to prostate-specific antigen screening: estimates from the European Randomized Study of Screening for Prostate Cancer. J Natl Cancer Inst 2003;95(12):868-78.
- Kvåle R, Auvinen A, Adami HO, et al. Interpreting Trends in Prostate Cancer Incidence and Mortality in the Five Nordic Countries. J Natl Cancer Inst 2007;99(24):1881-87.
- Data were provided by London School of Hygiene and Tropical Medicine on request, 2014.
About this data
Data is for: England and Wales, 1971-2011, ICD-10 C61