As with most cancers, survival for prostate cancer is improving. However, interpretation of prostate cancer survival trends is difficult as the case-mix on which they are based is likely to have changed over time with earlier diagnoses following the advent of TURP and PSA testing. The detection of a greater proportion of latent, earlier, slow-growing tumours in more recent time periods will have the effect of raising survival rates due to lead-time bias (that is, the difference in time between screen detection and clinical detection in the absence of screening).[1] Lead-time bias for prostate cancer is estimated to be between five and 12 years, varying with a man's age at screening.[2,3] Data from the European Randomized Study of Prostate Cancer estimates that for a single screening test, mean lead times are 12 years at age 55 and six years at age 75.[3] Some of the increase may also be attributed to genuine improvements in survival due to more effective treatment, for both early, aggressive prostate cancers and advanced cases.[4]
One-year 
net survival for prostate cancer has increased from 66% during 1971-1972 to 94% during 2010-2011 in England and Wales – an of 28 percentage points.[5]
Prostate Cancer (C61), Age-Standardised One-Year Net Survival, Men (Aged 15-99), England and Wales, 1971-2011
Survival at five years is strongly associated with the amount of PSA testing in the population, though improvements in treatment are likely to have had some impact.[4] Five-year age-standardised net survival for prostate cancer has increased from 37% during 1971-1972 to a predicted survival of 85% during 2010-2011 in England and Wales – an absolute survival difference of 48 percentage points.[5]
Prostate Cancer (C61), Age-Standardised Five-Year Net Survival, Men (Aged 15-99), England and Wales, 1971-2011
Ten-year survival has increased by an even greater amount than one- and five-year survival since the early 1970s. This is again generally attributable to PSA testing, as well as the success of treatment.[4] Ten-year age-standardised net survival for prostate cancer has increased from 25% during 1971-1972 to a predicted survival of 84% during 2010-2011 in England and Wales – an absolute survival difference of 59 percentage points.[5] Overall, more than 8 in 10 men diagnosed with prostate cancer today are predicted to survive their disease for at least ten years.
Prostate Cancer (C61), Age-Standardised Ten-Year Net Survival, Men (Aged 15-99), England and Wales, 1971-2011
References
- Parker C, Muston D, Melia J, et al. A model of the natural history of screen-detected prostate cancer, and the effect of radical treatment on overall survival. Br J Cancer 2006;94(10):1361-8.
- Pashayan N, Powles J, Brown C, et al. Excess cases of prostate cancer and estimated overdiagnosis associated with PSA testing in East Anglia. Br J Cancer 2006;95(3):401-5.
- Draisma G, Boer R, Otto SJ, et al. Lead times and overdetection due to prostate-specific antigen screening: estimates from the European Randomized Study of Screening for Prostate Cancer. J Natl Cancer Inst 2003;95(12):868-78.
- Kvåle R, Auvinen A, Adami HO, et al. Interpreting Trends in Prostate Cancer Incidence and Mortality in the Five Nordic Countries. J Natl Cancer Inst 2007;99(24):1881-87.
- Data were provided by London School of Hygiene and Tropical Medicine on request, 2014.
About this data
Data is for: England and Wales, 1971-2011, ICD-10 C61