Prostate cancer survival in Trinidad: Is PSA a prognostic factor?

Background: Prostate cancer is the most common malignancy among men in the western hemisphere, including Trinidad and Tobago. The aim of this study is to describe the epidemiological features of prostate cancer among patients admitted to a tertiary level teaching hospital during 2002 to 2005. We assessed the long-term survival of patients with prostate cancer and the epidemiology of the disease.

Methods: We reviewed the admissions data for the period 2002-2005. Demographic, clinical and outcomes (survival or death) data were collected and analysed, using SPSS version 16. Statistical analysis included Kaplan-Mier survival analysis, Cox regression models and the log-rank test. A p value of <0.05 was considered statistically significant.

Results: Of the 1250 cases reviewed, 242 participants were selected. Patients of African ancestry, older than 60 years and a Gleason score greater than 7 had an increased risk of mortality. Patients with prostate-specific antigen (PSA) ≥100 ng/L had a 3-fold increased risk of mortality. Survival rates declined between 2002 and 2005.

Conclusion: This is the first study of its kind to demonstrate survival rates among patients with prostate cancer in Trinidad. The following epidemiological features were identified: average age of occurrence of 71 years, ethnic disparity with higher occurrence in African men than all other ethnic groups and a PSA of >100 ng/dL. These features were associated with a 3-fold higher risk of death. A Gleason score of 8 to 10 was also associated with lower survival rates.