{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T10:36:20Z","timestamp":1777890980627,"version":"3.51.4"},"reference-count":41,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100023534","name":"DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100023534","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000780","name":"European Commission","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["U01CA184374"],"award-info":[{"award-number":["U01CA184374"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Emerging evidence indicates significantly poorer overall survival for men with metastatic prostate cancer in resource\u2010limited settings than in high\u2010income countries. However, there is less understanding of the overall survival of non\u2010metastatic disease, which could inform early treatment strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To prospectively examine factors associated with the National Comprehensive Cancer Network (NCCN) risk stratification and overall survival in 741 Black South African men with non\u2010metastatic prostate cancer, some of whom also had co\u2010morbidities (\u2265\u20092 other chronic conditions).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Baseline data on social and health factors were collected. Follow\u2010up of participants monitored overall survival over a median of 4.3 (3.5\u20135.0) years. We used multivariable proportional ordinal regression to examine factors associated with non\u2010metastatic prostate cancer risk stratification. Kaplan\u2010Meier, Cox proportional hazards regression, and Pohar\u2010Perme methods were used to calculate overall survival and assess associations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Our findings showed a generally favourable prognosis of non\u2010metastatic prostate cancer with a 5\u2010year overall survival of 79.0% (75.6\u201382.6) while the 5\u2010year age\u2010standardised net survival was 91.0% (95% CI 86.0\u201397.0). Overall survival differed significantly by the different NCCN risk groups, emerging early and widening over time, with the lowest survival in the high\u2010risk groups. Only older age at diagnosis (Hazard Ratio per one\u2010year increase:1.05 (95% CI: 1.02\u20131.08)), diabetes (HR: 1.70 (95% CI: 1.08\u20132.67)), and depression (HR: 1.67 (95% CI: 1.09\u20132.57)) at study recruitment were associated with poorer overall survival. Furthermore, only older age at diagnosis (HR: 1.04 (95% CI: 1.02\u20131.07)) was associated with higher non\u2010metastatic prostate cancer risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These findings emphasise the need to address early diagnosis and comorbidities in non\u2010metastatic prostate cancer, which could improve overall survival.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.71628","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T21:30:19Z","timestamp":1773005419000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Factors Associated With Risk Stratification and Overall Survival of Black South African Men With Non\u2010Metastatic Prostate Cancer"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9711-3348","authenticated-orcid":false,"given":"Raylton P.","family":"Chikwati","sequence":"first","affiliation":[{"name":"SAMRC Developmental Pathways for Health Research Unit, Department of Paediatrics University of the Witwatersrand  Johannesburg South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monica Ewomazino","family":"Akokuwebe","sequence":"additional","affiliation":[{"name":"SAMRC Developmental Pathways for Health Research Unit, Department of Paediatrics University of the Witwatersrand  Johannesburg South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olaide O.","family":"Ojoniyi","sequence":"additional","affiliation":[{"name":"SAMRC Developmental Pathways for Health Research Unit, Department of Paediatrics University of the Witwatersrand  Johannesburg South 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