No screening, no life: Perspectives from a sociodemographic characterization of prostate cancer patients.

BACKGROUND

Prostate cancer is the most common solid neoplasm in men, with an increasing incidence. This study describes clinical and sociodemographic features and PSA levels, and evaluate their associations with stage, risk categories, metastasis, and mortality in a public tertiary hospital in southern Colombia.

METHODOLOGY: The present retrospective cohort study included 590 patients diagnosed with prostate cancer between 2020 and 2023. Sociodemographic and clinical variables, PSA levels, pathological characteristics and risk scales were analyzed. Patients were categorized into two groups: living (n = 429) and deceased by prostate cancer (n = 109), and other causes (n = 44). Statistical analyses were performed to determine associations with mortality and presence of metastasis.

RESULTS

PSA screening was more frequent among survivors (66.9%, n = 287) than among deceased (22.0%, n = 24; p < 0.001). Median PSA at diagnosis was higher in those who died (123 vs 16 ng/mL; p < 0.001). PSA > 100 ng/mL was associated with ~50% probability of metastatic disease, rising to >95% for PSA > 323 ng/mL. High-risk D'Amico classification was strongly associated with metastasis (RR 6.67) and mortality (OR 14.24, p < 0.001). Bone pain was the predominant presenting symptom in the deceased group (76.1%, n = 83) and showed a strong association with metastasis (RR 8.146).

CONCLUSIONS

PSA screening was strongly associated with improved survival outcomes. Elevated PSA levels, high risk D'Amico classification and the presence of bone pain were important predictors of metastasis and mortality. The need to strengthen early detection in our population is evident, given the high percentage of patients presenting at advanced stages.