BACKGROUND: Men diagnosed with prostate cancer have higher rates of noncancer mortality than men in the general population which may or may not be related to treatment choices.
OBJECTIVES: To estimate the incidence of acute myocardial infarction (AMI), coronary artery disease (CAD), congestive heart failure (CHF), stroke, and sudden cardiac death (SCD) in patients diagnosed with prostate cancer.
METHODS: We conducted a retrospective cohort study of 71,838 men aged 65 years and older with an incident diagnosis of prostate cancer using data from the Surveillance, Epidemiology and End Results (SEER)-Medicare linked database. This datasource contains clinical and vital record information on individuals with incident cancers from population- based cancer registries within the United States (US) and links them to claims information for Medicare enrollees. Case definitions for each event of interest were based on algorithms from published studies. Estimated incidence rates for each event with associated 95% confidence intervals, stratified by stage of prostate cancer at diagnosis, age, and first course of treatment were generated.
RESULTS: The overall incidence per 1,000 person-years (95% CI) for each outcome was AMI 10.99 (10.58, 11.41), CAD 39.93 (39.14, 40.74), CHF 11.34 (10.93, 11.76), stroke 11.23 (10.81, 11.65), cardiovascular death 14.98 (14.51, 15.47), cerebrovascular death 3.65 (3.42, 3.89), and SCD 6.32 (6.02, 6.64). Event rates increased with age, were higher in patients enrolled with advanced (Stage 4) prostate cancer, and were substantially higher in patients with previous cardiovascular or cerebrovascular disease.
CONCLUSIONS: Incidence rates for certain medical conditions derived from SEER-Medicare linked data in the over-65 population can aid in understanding results of oncology clinical trials, which often have limited long-term follow-up data on the nonexperimental arms of the trials.
