Risk Factors for Cardiovascular-Specific Mortality in Patients With Prostate Cancer: A Surveillance, Epidemiology, and End Results (SEER)-Based Study

Background: Prostate cancer (PC) is responsible for large numbers of cancer-related deaths in males worldwide, and it has been linked to an increase in cardiovascular morbidity and mortality (CVM). The purpose of this research is to identify the incidence and risk factors for CVM in PC patients.

Methods: In this retrospective cohort study, we collected data from patients with PC diagnosed between 2000 and 2014 from the Surveillance, Epidemiology, and End Results (SEER) database. CVM among PC patients was identified and compared to the general population using the standardized mortality ratio (SMR). The multivariable competing risk model with subdistribution hazard ratio (SHR) was used to analyze the data in a more complex method to discover the risk factors associated with CVM among PC patients.

Results: Of the 171,147 identified PC patients, the median survival time was 117 months, with 17,168 dying from cardiovascular disease (CVD). Patients diagnosed at age 45-54 had a higher CVM risk than the age-standardized general population (SMR (95% CI): 19.01 (17.17-21.0)). Using multivariate competing risk regression analysis, aged 85 and older (SHR (95% CI): 20.9 (18.628-23.467)), black ethnicities (SHR (95% CI): 1.3 (1.264-1.398)), and patients without surgical intervention (SHR (95% CI): 1.35 (1.305-1.410)) had higher CVM. On the other hand, being of Asian/Pacific Islander or American Indian/Native Alaskan ethnicity (SHR (95% CI): 0.94 (0.891-0.993)), being diagnosed between 2007 and 2014 (SHR (95% CI): 0.63 (0.613-0.655)), and having an advanced disease stage and a lack of disease differentiation in the histology were found to be related with a lower CVM.

Conclusion: Patients with PC have a greater likelihood of dying from CVD. Several important risk factors for CVD have been discovered, including advanced age, black ethnicity, and patients without surgical intervention. These findings are limited by the retrospective nature of the analysis, relying solely on the SEER database, which imposes restrictions on accessing comprehensive patient data, including lifestyle factors and medical history.