54 - PROFILE AND OUTCOMES OF PROSTATE MALIGNANCY AMONG PATIENTS YOUNGER THAN FIFTY YEARS

Objectives: Prostate Cancer is the second most common malignancy in American men and is their second leading cause of cancer death. Prostate cancer generally develops in older men, with the average age of diagnosis being 66 years. Since it is rarely diagnosed in men under 40, the natural history of such early detection is not well documented in the literature. In this study, we aim to describe the disease characteristics and outcomes of patients with prostate cancer before the age of 50.

Methods: We utilized the National Cancer Database (NCDB) to conduct a retrospective analysis of patients with a primary diagnosis of prostate cancer from January 2004 to December 2018. Utilizing the cox regression model, we compared cancer-specific mortality between young patients, defined as those whose age was ≤ 50 years at diagnosis, and a control group of patients aged > 50. The multivariate analysis includes covariates such as patients’ race/ethnicity, socioeconomic status (annual median income, insurance type, and education level), Charlson comorbidity index, disease stage at presentation, and treatment modalities.

Results: There were 843,511 cases of prostate malignancy reported in the National Cancer Database between 2004 and 2018. About 6.3% of these patients were ≤ 50 years (N=52,890). Among the patients, 74.0% were whites, and 21.3% were Blacks. These compared to the control group of older patients, which includes 84.3% Whites and only 11.3% Blacks (p- < 0.001). A higher proportion of younger patients presented at stage 1 of the disease (43.7% vs. 33.6% p < 0.001). They also had a lower median PSA score (5.9 vs.6.7, p< 0.001) and higher Gleason score of < 6 (96.0% vs 93.7%, p, < 0.001). The 15-year cancer-specific survival among the younger patients was (90.0%: vs. 67.2%, p < 0.001). In the multivariate analysis, patients younger than 50 have overall better survival irrespective of race/ethnicity, HR=0.52 (95% CI 0.48-0.56, p < 0.001). ). In a sub-analysis, young Black patients with prostate cancer have better survival than older Black patients and comparable survival to young white patients with prostate cancer(see Table).

Conclusion: Young patients have better overall cancer-specific survival than their older counterparts. Black patients are overrepresented among young prostate cancer patients and may benefit from earlier screening.