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.

Biomedical Center Faculty of Medicine Charles University Pilsen 30605 Pilsen Czech Republic

Cancer Gene Therapy Group Translational Immunology Research Program University of Helsinki 00014 Helsinki Finland

Comprehensive Cancer Center Helsinki University Hospital 00290 Helsinki Finland

Department of Urology Helsinki University Hospital 00029 Helsinki Finland

Division of Cancer Epidemiology German Cancer Research Center Im Neuenheimer Feld 580 69120 Heidelberg Germany

Division of Pediatric Neurooncology German Cancer Research Center 69120 Heidelberg Germany

Hopp Children's Cancer Center 69120 Heidelberg Germany

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Critical survival periods in prostate cancer in Sweden explored by conditional survival analysis