THE NATIONAL-CANCER-DATA-BASE REPORT ON LONGITUDINAL OBSERVATIONS ON PROSTATE-CANCER

BACKGROUND. Data on 349,154 prostate cancer cases diagnosed since 1986 have been entered to the American College of Surgeons National Cancer Data Base (NCDB). Previous annual reports have examined subsets of th ese data. The present report highlights major trends in the presentati on and treatment of prostate cancer in the United States evident from longitudinal analyses of the entire data. METHODS. NCDB data are colle cted following a computerized, standard format. Hospital participation is voluntary. RESULTS. Since the first year of data collection, the n umber of participating hospitals has increased from 496 to 996 and the number of prostate cancer patients reported to the NCDB increased fro m 19,531 to 84,408. The proportion of men diagnosed at ages younger th an 70 years increased from 37.8% in 1986 to 46.9% in 1993, Completenes s of reporting stage of disease and tumor grade has improved, The prop ortions of both the earliest (American Joint Committee on Cancer [AJCC ] Stage Groups 0 and I) and the most advanced (AJCC Stage Group IV) st ages declined. The proportion of Grade 2 (moderately differentiated) t umors increased from 38.6% in 1986 to 57.5% in 1993. The proportion of AJCC Stage II prostate cancer increased from 19% in 1986 to 48.4% in 1993. The proportion of patients treated by prostatectomy increased fr om 9.9% in 1985 to 29.2% in 1993. The proportion of patients receiving no cancer directed treatment declined from 41.8% in 1986 to 21.6% in 1993. Less change was observed in the use of radiation and hormonal tr eatments. CONCLUSIONS. These data show that the clinical patterns of p rostate cancer have changed markedly in recent years. (C) 1996 America n Cancer Society.