- prostate cancer in Kurdistan Province-Iran:. - Background: The population-based survival rate is affected by the quality and effectiveness of health care systems.. - Overall, the survival of prostate cancer (PC) patients has improved over the past two decades worldwide. - This study aimed to determine the overall survival rate and correlate it with the prognostic factors in patients with PC diagnosed in Kurdistan province.. - Conclusions: This study demonstrated that factors such as age at diagnosis, level of education, occupation, AJCC stage of disease, Gleason score, and type of treatments were influential factors in the survival of PC patients in Kurdis- tan province and needed more attention.. - Prostate cancer (PC) is the second most prevalent can- cer and the cause of the sixth cancer-caused death in men worldwide [1]. - Considering that long-term survival following prostate cancer treatment is widespread, it is crucial to estimate the survival rate and prepare the ground to meet the unique requirements of these patients [11–13].. - How- ever, despite the ever-increasing recognition of the long- term outcomes of prostate cancer diagnosis, research works on this field are still disorganized [13, 14]. - In Iran, the survival rate of PC is mainly based on the informa- tion of hospital files, so the five-year survival rate, accord- ing to some studies, is about 36% [15]. - The survival rate based on population is affected by the quality and effec- tiveness of health care systems. - In general, the survival rate of PC patients has been growing over the past few decades, especially in European countries [16, 17]. - A deprivation gap was observed among patients with prostate cancer diagnosed in Scotland during . - In this retrospective cohort study, 410 patients with PC were collected from the cancer registry system in the Kurdistan University of Medical Sciences from 2011 to 2018. - The 1, 3, and 5 years’ survival rate and median of survival were investigated based on the variables under study.. - The difference in survival rate was measured for the sub- groups using the log-rank test. - There were no viola- tions of the proportionality assumption for any of the covariates included in the PC-specific models. - The results indicated that 1, 3, and 5 years’ survival rate was 93, 64.1, and 40.7%, respectively, with mid survival of 49 months (95% CI 55.6-49) (Fig. - The log-rank test indicated that the survival rate of prostate cancer was different depending on diagnosis time (P<0.001) (Fig. - On the other hand, the survival rate was not significantly related to marital sta- tus, history of smoking and drinking, and history of pros- tate cancer in the family (P>0.05) (Table 1).. - Multiple Cox regression analysis results showed that individuals older than ≥81-years old had a lower survival rate (HR=2.23, 95% CI P=0.009). - Univariable regression results indicated that individuals living in the city had a higher survival rate than those living in rural areas (HR=0.74, 95% CI:. - However, multiple regression results indicated no significant difference (P=0.067), and the survival rate in individuals with a university degree was higher (HR=0.78, 95% CI P=0.042). - However, those who received ADT treatment did not have a significantly different survival rate (Table 2).. - The survival rate of 1, 3, and 5 years were 93, 64.1, and 40.7%, respectively.. - The present study results showed that the mean ± SD age at diagnosis was 68.3±9.82 years, and in a study in Yazd Province-Iran on 113 patients with prostate cancer was 67.3±9.82 years the five-year survival rate was 36.1%. - Between 1992 and 2000, PC’s relative five- year survival rate in China was 32.5% [22]. - However, the five-year survival rate of prostate cancer in South Korea in 1996 and between 2010 and 2014 was 67.2 and 93.3%, respectively, which is ascending [23, 24]. - The survival rate of PC patients has been ascending over the past few years [26].. - In all regions, the five-year survival rate increased from 83% in the late 1980s to 99% in late . - According to Colman et al., the five-year survival rate in 31 countries showed a wide range of changes in survival rate in different age groups in different countries. - Even after adjusting to cover differences in mortality rate due to other causes, the difference was still considerable in the USA, so the survival rate of Caucasians was higher than Afro-Americans (92.4 vs. - The Steele et al. - study showed that the one-year and five-year survival rate was notably higher than previous periods like 2002-2003 and . - Critz et al.. - reported a 10-year survival rate of prostate cancer in their study in 2013, approximately 75% in the USA [31], which is two times more than what was reported by a meta- analysis study on 11 studies, which was equal to 36.2%. - In addition, the survival rate was higher in countries with higher HDI [15]. - treatments and interventions and an increase in HDI, the survival rate of PC patients has been increasing [27, 32].. - prostate cancer showed that 19 patients [21%] were younger than 60 years old. - 2 Kaplan–Meier curves of prostate cancer-specific survival across age at diagnosis. - The population-based study in the United States showed that survival PC patients were more deficient among the youngest (40-44 years) and oldest patients.. - 3 Kaplan–Meier curves of prostate cancer -specific survival across AJCC stage of disease. - 4 Kaplan–Meier curves of prostate cancer -specific survival across Gleason score. - There was no significant relationship between smok- ing and drinking history and survival of prostate cancer;. - For example, high-risk behaviors such as smoking and drinking are more com- mon in lower socioeconomic groups, partially explain- ing the lower survival rate in these groups [37, 38]. - A study by Xu et al. - in China illustrated that there was a Table 2 Univariate and multivariate cox regression analysis for 5-year overall survival rate. - significant difference between PC patients with hyper- tension (28.5%) and a control group (48.3%) in terms of five-year survival rate [39]. - More than 90% of PC cases are diagnosed in the early stages, so relative five- year survival is close to 100% (tumor staging data are not accurately recorded). - and orchiec- tomy had a higher survival rate than patients who did not receive any treatment, indicating the effect of treatment on survival. - In the study, Kenrick et al. - 21.8 months’ white men (HR=0.81, P=0.08) with metastatic castration-resistant prostate cancer. - The result of a population-based cohort study showed, In age-adjusted and multivariable-adjusted analyses, sta- tin use after ADT was associated with a decreased risk of prostate cancer death (HR=0.82. - Treatment can affect the survival rate of cancer patients, while there is ambiguous evidence about the effect of treatment methods on survival rate. - Large- scale trial studies on men with PC in the early stages of PSA showed that the advantages of radical treatment are higher than active surveillance. - It is not easy to conclude that treatment affects the survival rate [46, 47].. - There has been an improvement in the survival rate of PC patients in the UK over the past two decades. - Still, survival rate inequality based on socio- economic has been reported by some studies in the UK, Wales, and Scotland [17].. - A meta-analysis study on the survival rate of PC patients in Asia showed that the highest survival rate was in Asian people living in the UK, followed by Japa- nese. - On the other hand, China had the lowest one-year survival rate. - Higher HDI is related to a higher survival rate as countries like Japan and Singapore with higher HDI had a higher survival rate. - That is not true in India as, although the survival rate is high, HDI in India is lower than that of China [15]. - A wide range of factors can affect prostate cancer sur- vival in less developed regions, such as diagnosis age, stage of the disease, invasiveness of the disease, co-mor- bidity, and unhealthy habits [48].. - Essential factors in the difference in prostate cancer sur- vival rate in Kurdistan province can be the lack of prostate cancer screening, lack of awareness of the symptoms of the disease, late referral of patients (diagnosis of disease in old age), and tumor progression is. - This study demonstrated that factors such as age at diagno- sis, level of education, occupation, AJCC stage of disease, Gleason score, and type of treatments were influential fac- tors in the survival of PC patients in Kurdistan province and needed more attention.. - 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