Calculator for Estimating Overall Life Expectancy and Lifetime Risk for Prostate Cancer Death in Newly Diagnosed Men Managed without Definitive Local Therapy

The method used by the calculator is described in:

Kim HL, Puymon, MR, Qin M, Guru K, Mohler JL. A Method for Using Life Tables to Estimate Lifetime Risk for Prostate Cancer Death. JNCCN 2010; 8: 148-154.

Age: years old ( 50 - 105 )

Gleason Score: Mortality Rate

Lead Time years

Quartile of Health:



Life Expectancy: years

Death Risk of Prostate Cancer: %

Instruction/background:

The Social Security Life Tables are commonly used to estimate life expectancy. However, these tables apply to the general U.S. population and are less accurate for men who have been diagnosed with prostate cancer. This calculator generates a new life expectancy by adjusting the life expectancy from the Social Security Life Tables using the mortality rates associated with watchful waiting. The watchful waiting mortality rates are from a publication by Albertsen et. al (2005), which describes survival for patients diagnosed with prostate cancer before PSA came into use and who did not receive definitive local therapy. Researchers with access to mortality rates from other studies can specify a custom mortality rate (deaths per 1000 person-years) by selecting "custom mortality rate". The calculator also estimates the risk of dying from prostate cancer during the expected years of life.

Albertsen PC, Hanley JA, Fine J. 20-year outcomes following conservative management of clinically localized prostate cancer. JAMA 2005;293:2095-2101.

Gleason score: Enter the overall Gleason score from the prostate biopsy.

Lead time: The mortality rates reported by Albertsen et. al (2005) were based on patients diagnosed with prostate cancer before PSA came into use. PSA screening leads to earlier detection of cancer, which is referred to as lead time. Therefore, if a cancer is detected as a result of PSA screening, and not as a result of cancer-related symptoms, a lead time should be included. It is estimated that PSA screening can lead to a lead time of approximately 10 years; however, there is no consensus amongst researchers on how to estimate lead time and lead time estimate may differ based on age.

Quartile of Health: Life expectancy can be adjusted by categorizing men based on their overall health status, which is divided into four "quartiles". Although lead time can apply to men in all quartiles of health, a limitation of our mathematical model is that it can not simultaneously accept as inputs a non-zero lead time and a quartile other than the middle two quartiles. This limitation is inherent to the mathematical method and a full discussion is beyond the scope of this presentation.