Incidence of prostate cancer and net survival by grade in a geriatric population: A population-based study in a French administrative entity from 1991 to 2013

Background: Prostate cancer is the leading type of cancer among men in more developed countries. Incidence trends and survival rates could differ by age groups considering potential differences in the frequency of PSA testing, types of cancers and medical management. Our objective was to compare incidence trends and survival rates of prostate cancer between men aged >= 75 and 60-74 years. Method: We analyzed data from a population-based cancer registry in Isere, France. All men aged >= 60 years diagnosed with an incident prostate cancer during the 1991-2013 period were included. Incidence and mortality rates were computed as well as net survival rates. Results: In 2013, observed incidence rates were 557.6 and 568.7 per 100,000 for men aged 60-74 and >= 75, respectively, with high grades cancers more frequent among elderly men. The incidence and mortality trends among men aged >= 75 included a period of stability followed by a decreasing trend from 2003, whereas a peak of incidence was observed in 2005 for men aged 60-74. For both age groups, net survival rates increased with period of diagnosis and 8-year net survival remained higher than 70% for cases diagnosed in the 2000-2004 period. Lower survival rate of 51% (95% CI: 42%; 60%) was observed for high grades cancers diagnosed among men aged 75-84 in 2000-2004. Conclusion: The epidemiology of prostate cancers among men aged >= 75 include a decrease of incidence and mortality rates from 2003, an important proportion of high grade cancers and a relatively good prognosis except for high grade cancers.