Long-Term Periodic and Conditional Survival Trends in Prostate, Testicular, and Penile Cancers in the Nordic Countries, Marking Timing of Improvements

SIMPLE SUMMARY: Male cancers include common prostate cancer (PC) and the much rarer testicular (TC) and penile cancers. Recent survival data for these cancers are relatively good, but long-term studies are rare. To analyzed relative survival in these cancers, we used the NORDCAN database with information from Denmark, Finland, Norway, and Sweden over a 50-year period (1971–2020). Survival improved early for TC, and 5-year survival reached 90% after 1985. Towards the end of the follow-up, TC patients who had survived the 1st year survived the next 4 years with a comparable probability to the background population. For PC, 90% survival was reached after 2000. For penile cancer, 5-year survival never reached 90%, and the improvements in survival were modest at best. As conclusions, more than 90% of the patients diagnosed with PC and TC are alive 5 years later compared to men in general. For penile cancer, mortality is higher, and early symptoms should be discussed with the doctor. ABSTRACT: Survival studies are important tools for cancer control, but long-term survival data on high-quality cancer registries are lacking for all cancers, including prostate (PC), testicular (TC), and penile cancers. Using generalized additive models and data from the NORDCAN database, we analyzed 1- and 5-year relative survival for these cancers in Denmark (DK), Finland (FI), Norway (NO), and Sweden (SE) over a 50-year period (1971–2020). We additionally estimated conditional 5/1-year survival for patients who survived the 1st year after diagnosis. Survival improved early for TC, and 5-year survival reached 90% between 1985 (SE) and 2000 (FI). Towards the end of the follow-up, the TC patients who had survived the 1st year survived the next 4 years with comparable probability to the background population. For PC, the 90% landmark was reached between 2000 (FI) and after 2010 (DK). For penile cancer, 5-year survival never reached the 90% landmark, and the improvements in survival were modest at best. For TC, early mortality requires attention, whereas late mortality should be tackled for PC. For penile cancer, the relatively high early mortality may suggest delays in diagnosis and would require more public awareness and encouragement of patients to seek medical opinion. In FI, TC and penile cancer patients showed roughly double risk of dying compared to the other Nordic countries, which warrants further study and clinical attention.