Prostate cancer is the most common cancer affecting men in the United Kingdom. The majority of men with prostate cancer will have a slow growing form of the cancer and survive for years after diagnosis. Researchers have shown that there are certain factors that are related to whether a man will die from prostate cancer, including body mass index (BMI), ethnic background and family history of prostate cancer. There are other factors that researchers think might also be related. These include lifestyle factors (e.g. high fat diet), medications (e.g. statins), and other medical problems (e.g. diabetes). Our study will use a database of anonymised GP records and information from the national prostate cancer register. We will examine the records of men who have been diagnosed with prostate cancer and assess what routinely recorded factors are related to whether or not a man is at greater risk of dying from his prostate cancer or further spread of the disease after being diagnosed. This study could be the first step in developing a new way to predict which men with prostate cancer will have more aggressive, potentially fatal disease, so they and their clinicians are better informed when making decisions about treatments.
The objective of this study is to establish which risk factors are associated with prostate cancer progression using primary care medical records data. Prostate cancer progression can be defined as the occurrence of one of the following after diagnosis of localised disease; development of metastases, change in treatment, or death. Our retrospective cohort study will include 57,318 men with prostate cancer diagnosed in between 1st January 1987 and 31st July 2016; 22,080 of whom died during the study period. We will use the Clinical Practice Research Datalink (CPRD) to gather information on demographics and risk factors identified a priori, and linked data from the Office for National Statistics (ONS) and the National Cancer Registration and Analysis Service (NCRAS) on cancer stage/grade and mortality. Cox proportion hazard regression and survival analysis using flexible parametric models will be utilised to determine factors associated with mortality in men with prostate cancer accounting for competing risks of other causes of death. This study could be the first step in developing a way to predict which men with prostate cancer will have more aggressive disease. It will inform development of a risk prediction tool to help GPs and specialists advise their patients and inform treatment decisions.
Prostate cancer mortality; All-cause mortality; Non-prostate cancer mortality; Spread of disease; Commencing systemic treatment.
Sam Merriel - Chief Investigator - University of Exeter
Sam Merriel - Corresponding Applicant - University of Exeter
Margaret May - Collaborator - University of Bristol
Richard Martin - Collaborator - University of Bristol
NCRAS Cancer Registration Data;ONS Death Registration Data