---
title: "Prostate Cancer Survival and Mortality Predictors in 10,556 Brazilian Patients"
id: "pubmed-42674784"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42674784"
content_type: "clinical_feed_article"
specialty: "Oncology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42674784/"
doi: "10.1002/cnr2.70667"
published_at: "2026-09-01T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Prostate Cancer Survival and Mortality Predictors in 10,556 Brazilian Patients
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42674784
- **Specialty:** [Oncology](https://medichelpline.com/clinical-feed/oncology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42674784/)
- **DOI:** [10.1002/cnr2.70667](https://doi.org/10.1002%2Fcnr2.70667)
- **Published At:** 2026-09-01T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This retrospective cohort analyzed **10,556** men diagnosed with **prostate cancer (PCa)** in a Brazilian state between 2000–2016 with follow-up through 2021. - Data came from hospital-based cancer registries linked to the state Mortality Information System; outcomes were PCa death, other-cause death, or alive at end of follow-up. - At end of 2021, 6,388 patients were alive, 1,936 died from PCa, and 2,232 died from other causes; 5-year **PCa-specific survival** was **87.7%**. - Cause-specific Cox models identified higher age at diagnosis (per 10-year increment) as associated with increased PCa mortality (HR 1.14; 95% CI 1.06–1.22). - **Lower educational level** was linked to higher mortality; basic education (HR 0.82; 95% CI 0.71–0.95) and middle/high education (HR 0.64; 95% CI 0.52–0.80) had lower risk compared with no formal education. - Referral from non-SUS services showed a modestly higher PCa mortality risk (HR 1.14; 95% CI 1.00–1.30). - Treatment associations: **surgery** was associated with lower cause-specific hazard (HR 0.41; 95% CI 0.33–0.52), while **hormone therapy** associated with higher hazard (HR 1.98; 95% CI 1.75–2.24). - Authors caution that treatment-related associations likely reflect disease severity and selection rather than causal treatment effects. - Key conclusions emphasize the roles of **age**, **educational level**, **distant metastasis**, referral source, and treatment patterns; recommendations include earlier diagnosis, addressing social inequalities, and strengthening oncology care networks.
## Clinical Analysis & Structured Key Points
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Affiliations Expand ### Affiliations * 1 Graduate Program in Public Health, Health Sciences Center, Federal University of Espírito Santo (UFES), Vitoria, Espírito Santo, Brazil. * 2 Department of Applied Mathematics, Northern Espirito Santo University Center at the Federal University of Espírito Santo (UFES), São Mateus, ES, Brazil. * 3 Secretaria de Estado da Saúde Do Espírito Santo, Special Epidemiological Surveillance Nucleus, Instituto Capixaba de Ensino, Pesquisa e Inovação (ICEPi), Vitória, Espírito Santo, Brazil. * 4 Department of Noncommunicable Diseases (NCDs) and Mental Health (NMH), Pan American Health Organization-PAHO, Washington, DC, USA. * PMID: **42674784** * DOI: [ 10.1002/cnr2.70667 ](https://doi.org/10.1002/cnr2.70667) Item in Clipboard # Survival and Mortality Predictors in Prostate Cancer: A Retrospective Cohort of 10 556 Brazilian Patients Wesley Rocha Grippa et al. Cancer Rep (Hoboken). 2026 Sep. Show details Display options Display options Format Abstract PubMed PMID Cancer Rep (Hoboken) Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Cancer+Rep+%28Hoboken%29%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Cancer+Rep+%28Hoboken%29%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42674784/) . 2026 Sep;9(9):e70667. doi: 10.1002/cnr2.70667. ### Authors [Wesley Rocha Grippa](https://pubmed.ncbi.nlm.nih.gov/?term=Grippa+WR&cauthor_id=42674784)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42674784/#short-view-affiliation-1 "Graduate Program in Public Health, Health Sciences Center, Federal University of Espírito Santo \(UFES\), Vitoria, Espírito Santo, Brazil.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42674784/#short-view-affiliation-2 "Department of Applied Mathematics, Northern Espirito Santo University Center at the Federal University of Espírito Santo \(UFES\), São Mateus, ES, Brazil."), [Larissa Soares Dell'Antonio](https://pubmed.ncbi.nlm.nih.gov/?term=Dell%27Antonio+LS&cauthor_id=42674784)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42674784/#short-view-affiliation-3 "Secretaria de Estado da Saúde Do Espírito Santo, Special Epidemiological Surveillance Nucleus, Instituto Capixaba de Ensino, Pesquisa e Inovação \(ICEPi\), Vitória, Espírito Santo, Brazil."), [Cristiano Soares Dell'Antônio](https://pubmed.ncbi.nlm.nih.gov/?term=Dell%27Ant%C3%B4nio+CS&cauthor_id=42674784)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42674784/#short-view-affiliation-3 "Secretaria de Estado da Saúde Do Espírito Santo, Special Epidemiological Surveillance Nucleus, Instituto Capixaba de Ensino, Pesquisa e Inovação \(ICEPi\), Vitória, Espírito Santo, Brazil."), [Luciane Bresciani Salaroli](https://pubmed.ncbi.nlm.nih.gov/?term=Salaroli+LB&cauthor_id=42674784)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42674784/#short-view-affiliation-1 "Graduate Program in Public Health, Health Sciences Center, Federal University of Espírito Santo \(UFES\), Vitoria, Espírito Santo, Brazil."), [Luís Carlos Lopes-Júnior](https://pubmed.ncbi.nlm.nih.gov/?term=Lopes-J%C3%BAnior+LC&cauthor_id=42674784)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42674784/#short-view-affiliation-1 "Graduate Program in Public Health, Health Sciences Center, Federal University of Espírito Santo \(UFES\), Vitoria, Espírito Santo, Brazil.")[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42674784/#short-view-affiliation-4 "Department of Noncommunicable Diseases \(NCDs\) and Mental Health \(NMH\), Pan American Health Organization-PAHO, Washington, DC, USA.") ### Affiliations * 1 Graduate Program in Public Health, Health Sciences Center, Federal University of Espírito Santo (UFES), Vitoria, Espírito Santo, Brazil. * 2 Department of Applied Mathematics, Northern Espirito Santo University Center at the Federal University of Espírito Santo (UFES), São Mateus, ES, Brazil. * 3 Secretaria de Estado da Saúde Do Espírito Santo, Special Epidemiological Surveillance Nucleus, Instituto Capixaba de Ensino, Pesquisa e Inovação (ICEPi), Vitória, Espírito Santo, Brazil. * 4 Department of Noncommunicable Diseases (NCDs) and Mental Health (NMH), Pan American Health Organization-PAHO, Washington, DC, USA. * PMID: **42674784** * DOI: [ 10.1002/cnr2.70667 ](https://doi.org/10.1002/cnr2.70667) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Background:** Prostate cancer (PCa) remains one of the most frequently diagnosed malignancies worldwide and represents a major contributor to premature mortality among men. This study aimed to estimate survival and investigate factors associated with PCa-specific mortality among men treated within the oncology care network of a Brazilian state. **Material and methods:** Retrospective cohort study was conducted using data obtained from hospital-based cancer registries linked to the state Mortality Information System. The cohort included 10 556 men diagnosed with PCa between 2000 and 2016, with follow-up through 2021. Outcomes were categorized as death from PCa, death from other causes, or alive at the end of follow-up. Associations with PCa-specific mortality were examined using cause-specific Cox proportional hazards regression models. **Results:** At the end of 2021, 6388 patients were alive, 1936 had died from PCa and 2232 deaths from other causes. The 5-year PCa-specific survival was 87.7%. In the multivariable analysis, increasing age at diagnosis (per 10-year increment) was associated with a higher cause-specific hazard of PCa mortality (HR = 1.14; 95% CI: 1.06-1.22). Lower educational level was also associated with increased mortality, while patients with basic education (HR = 0.82; 95% CI: 0.71-0.95) and middle or high education (HR = 0.64; 95% CI: 0.52-0.80) showed a lower risk of death compared to those with no formal education. Referral from non-SUS services was associated with a slightly higher risk of PCa mortality (HR = 1.14; 95% CI: 1.00-1.30). Regarding treatment variables, surgery was associated with a lower cause-specific hazard of mortality (HR = 0.41; 95% CI: 0.33-0.52), whereas hormone therapy was associated with an increased cause-specific hazard of death (HR = 1.98; 95% CI: 1.75-2.24). **Conclusions:** Age, educational level, presence of distant metastasis, referral source, and treatment modalities were associated with PCa-specific mortality. However, treatment-related associations should be interpreted with caution, as they likely reflect underlying disease severity and treatment selection patterns rather than causal effects. These findings highlight the importance of early diagnosis, reducing social inequalities in access to care, and strengthening oncology care networks to improve outcomes in patients with PCa. © 2026 The Author(s). Cancer Reports published by Wiley Periodicals LLC. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## References 1. 1. A. M. Filho, M. Laversanne, J. Ferlay, et al., “The GLOBOCAN 2022 Cancer Estimates: Data Sources, Methods, and a Snapshot of the Cancer Burden Worldwide,” International Journal of Cancer 156, no. 7 (2025): 1336–1346, . 2. 1. Z. Zhai, Y. Zheng, N. Li, et al., “Incidence and Disease Burden of Prostate Cancer From 1990 to 2017: Results From the Global Burden of Disease Study 2017,” Cancer 126, no. 9 (2020): 1969–1978. 3. 1. Instituto Nacional de Câncer (Brasil), Estimate 2026: Cancer Incidence in Brazil (INCA, 2026), 168, [https://ninho.inca.gov.br/jspui/bitstream/123456789/17914/1/Estima2026_c...](https://ninho.inca.gov.br/jspui/bitstream/123456789/17914/1/Estima2026_completo%20%281%29.pdf). 4. 1. F. Bray, M. Laversanne, H. Sung, et al., “Global Cancer Statistics 2022: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries,” CA: A Cancer Journal for Clinicians 74, no. 3 (2024): 229–263, . 5. 1. L. C. Lopes‐Júnior and L. C. Veronez, “Personalized Care for Patients With Cancer in the Precision‐Medicine Era,” International Journal of Environmental Research and Public Health 20, no. 4 (2023): 3023, . Show all 53 references ## MeSH terms * Aged Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Aged%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Aged) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42674784/) * Brazil / epidemiology Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Brazil%2Fepidemiology%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Brazil) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42674784/) * Cause of Death Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Cause+of+Death%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Cause+of+Death) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42674784/) * Educational Status Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Educational+Status%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Educational+Status) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42674784/) * Humans Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Humans%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Humans) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42674784/) * Male Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Male%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Male) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42674784/) * Middle Aged Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Middle+Aged%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Middle+Aged) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42674784/) * Prognosis Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Prognosis%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Prognosis) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42674784/) * Prostatic Neoplasms* / mortality Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Prostatic+Neoplasms%2Fmortality%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Prostatic+Neoplasms) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42674784/) * Prostatic Neoplasms* / pathology Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Prostatic+Neoplasms%2Fpathology%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Prostatic+Neoplasms) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42674784/) * Prostatic Neoplasms* / therapy Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Prostatic+Neoplasms%2Ftherapy%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Prostatic+Neoplasms) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42674784/) * Registries / statistics & numerical data Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Registries%2Fstatistics+and+numerical+data%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nl
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