HealingWell
Search Close Search
☰

Trends in PC DX and PC deaths, very puzzling numbers.

Support Forums
>
Prostate Cancer
✚ New Topic ✚ Reply
1 2 3
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 9/17/2014 5:24 AM (GMT 0)
John T, I believe you're right on the numbers being behind on the deaths. These new treatments will not be reflected in this sort of statistical jumble for another 15-20 years. It would make more sense to attempt to correlate the number of deaths with the number Dxed 15-20 years earlier to getting the treatments to correspond with the death rates, don't you think? . . . Q
Posted 9/17/2014 3:23 PM (GMT 0)
OK John,
Thx for clearing that up. And now I can see your point. Looking at it over a 29 year period, a period of supposedly much improved treatment and def early Dx, you would indeed expect to see the % dying to drop, even if it is based on the ever smaller # of men being Dx'ed. A smaller # Dx'edn which I have presumed is because so many men, such a large % of the population of men over 40 or 50, have already been Dx'ed.

To me, even though I can agree you would still expect this # to drop, calculating the % dying from the # of new cases just leads to confusion for my old brain. Wouldn't it make more sense to calculate that on the total # of men on record as having been Dx'ed with PC? Maybe breaking it down further by Gleason, etc?

Because, that # is probably(maybe), more or less the same as it has always been. X % of American male population/per 100,000 had PC back in 92 and it is likely about the same today. Could be a little lower due to lifestyle changes or a bit higher due to environmental changes, who knows. But I would not think there was a big difference either way.

However, probably because so much of the population has already been tested, the #s of newly diagnosed cases drops steadily. Even if I would expect to see the % of this # dying to also decrease over a 20 year period if consistently calculated in the same way, I still see a problem with the usefulness of this number.

To see what I mean, assume that as of last year we have reached a stage where every man in USA has been tested at least once. And thus the # of brand new cases Dx'ed now only consists of brand spanking new cases almost all caught very early, and almost zero guys who have been carrying around PC for 5 or 10 years. That's all we can expect now, the huge peak results in Dx of early the PSA days is long over.

But now assume that, for some environmental, vaccine or dietary reason or combo thereof, the # of new cases being detected now drops almost to zero. Like Polio or Small Pox in the past, new cases of PC is just not happening anymore. If that miracle occurred, most likely the absolute numbers of men dying from PC diagnosed 3 or 5 or 20 years before would probably not change much compared to the year before. (Barring some great improvement in treatment also coming on board the year before, assume it did not)

So, what would happen to the to the % of men dying based on the #s of new cases? Would it not skyrocket to 50 or 90%? ( or am I making an error here, I admit confusion up front) The same or possibly slightly fewer man would be dying, but based on a comparison to the plummeting #s of new cases, the % would take off.

In the same way, if you had significantly fewer men dying of PC every year due to improved treatment and catching it early, men diagnosed as much as 20+ years previously, still, if the #s of newly diagnosed is dropping at the exact same rate as the numbers of men with mostly older cases of PC, then the % stays the same. If it gets to the point where the newly diagnosed cases are dropping way faster than men staying alive due to treatment/early diagnoses, then the % dying goes way up. The % of men with PC that die of PC may be down quite a bit, but that % could still go up.

So unless I am missing something(am I?), I'm just not sure how useful that % of new cases dying is to me. As in my above example, I can see how it would be possible for fewer men per 100,000 to be going down but that particular % could be going up.

Seems to me that the useful # or % that we need to know is: Of the total # of men diagnosed with PC, what % of them, or how many men per 100,000 with PC, died of PC this year compared to 2004 or 1992 or 1985? That would tell us a whole lot. To me, that would be real clear info. If that #, along with how many years men live after diagnose, was unchanged or worse then I think we could say that all that we go through treatment wise is worthless or harmful.

Do we have that statistic? ( again, I apologize if I am just being extremely dense)
I have more, but I'm going to put it in a new post)
Bill
Posted 9/17/2014 3:34 PM (GMT 0)
I know I asked for the % dying based on the total # of men with PC rather than % of new cases. But seems to me just looking at the decreasing #s of PC deaths really tells us all we need to know. If we don't have the total # of men Dx'ed with PC, then we can just use the ever increasing total population of US men as a proxy, and calculate the significantly dropping PC death rate per decade from that. Coincidentally(?), dropping consistently with the start of wide spread PSA testing and early detection.

It seems to me there is a different way to look at it, the bottom line regarding deaths. No matter how you calculate the #s, the total numbers dying has dropped dramatically since the era of PSA began, even as population steadily increases.

In 1975, only 94/100,000 were newly diagnosed, but fully 1/3 of those died from PC before something else could kill them. 32/100,000 died, or 32% of the 94/100,000 actually diagnosed by way of symptoms.

Amazingly, in 1992(PSA era) the sheer #s dying of PC skyrocketed by 25%, but I bet that was mostly due to more men being diagnosed before they could die of other stuff.(EDIT: IOW, now we knew they had PC and before then we didn't) In 1975, plenty may have died of "bone cancer" etc that originated in the prostate, not counting the multitudes who died with undiagnosed PC but from something else. But, by 1992, as the PSA ball really got rolling, the % of those diagnosed with PC dying of PC was cut in half. EDIT:Why? Early detection?

In a mere 8 more years(2000), the numbers of men with PC dying from it dropped another 22.4% in absolute #s. That is huge, though the % of new cases dying remained the same.

In 11 more years(2011), the absolute numbers per 100,000 dying dropped an additional spectacular 31.5%!

The total drop in men per 100,000 dying from PC has dropped an incredible 46.93% since wide spread PSA started in 1992 and/or since improved treatment has become available. I doubt any of us think that USA men are mysteriously getting less PC, do we? And it is not just taking the PSA test that is causing a large decrease in total #s of men dying of PC. So, what are the likely culprits for this drop in #s of PC deaths other than early detection and/or improved treatment?

The % of the total male population dying from PC has dropped dramatically even since 2000. May the trend continue onward, whatever the cause!

Bill

Post Edited (BillyBob@388) : 9/17/2014 1:53:38 PM (GMT-6)

Posted 9/17/2014 4:35 PM (GMT 0)
Bill, that method would be great, but I don't know if it exists. I can find 5 year numbers that reflect what you are looking at, but 5 years is way too soon.
I'm going to start another thread about the numbers as we are just rehashing the same thing.
✚ New Topic ✚ Reply
123