PT - JOURNAL ARTICLE AU - Park, Jinsung AU - Han, Kyung-Do AU - Shin, Dong Wook AU - Park, Sanghyun AU - Shin, Hyun Bin TI - Conditional relative survival and competing mortality of prostate cancer patients in Korea: a nationwide cohort study AID - 10.1158/1055-9965.EPI-20-1084 DP - 2020 Jan 01 TA - Cancer Epidemiology Biomarkers & Prevention PG - cebp.1084.2020 4099 - http://cebp.aacrjournals.org/content/early/2020/11/13/1055-9965.EPI-20-1084.short 4100 - http://cebp.aacrjournals.org/content/early/2020/11/13/1055-9965.EPI-20-1084.full AB - Background: Conditional relative survival (CRS) and competing mortality are important survivorship issue after cancer treatment. We aimed to investigate them among patients with prostate cancer (PC) treated by various modalities. Methods: Using a nationwide population-based database, we calculated 5-year CRS conditioned on 1 through 5 years survival after diagnosis. These rates were stratified by age, sex, socioeconomic status, comorbidities, and treatment received. Cause of death and estimated cause-specific mortality were also described and considered with competing risks. Results: A total of 81,773 patients newly diagnosed with primary PC from 2007 to 2013 were identified. The 5-year CRS was 81.1% at baseline but increased gradually up to 95.4% at 4 years and exceeded 100% at 5 years after diagnosis, suggesting no excess mortality compared to the general population. However, this pattern differed by treatment received. Patients who underwent ADT showed 5-year CRS of only 88.4% at 5 years after diagnosis, implying persistent excess mortality. PC constituted around one third of deaths, while other cancers were responsible for the main cause of death within <2 years after diagnosis. Non-cancer deaths including cardiovascular disease and respiratory disease increased with time since diagnosis. Conclusion: CRS rates for patients with PC improved over time and exceeded that of the general population at 5 years. Other cancers were the main cause of death in the earlier survivorship phase, and death from non-cancer causes gradually increased over time. Impact: Our findings will help patients and clinicians make evidence-based decisions based on a patient's dynamic risk profile.