Journal article
Self-Reported Health Status Predicts Other-Cause Mortality in Men with Localized Prostate Cancer: Results from the Prostate Cancer Outcomes Study
Journal of general internal medicine : JGIM, Vol.30(7), pp.924-934
07/2015
DOI: 10.1007/s11606-014-3171-8
PMCID: PMC4471031
PMID: 25678374
Abstract
Background: Guidelines recommend against treating localized prostate cancer (PCa) in men with a greater than 10-year life expectancy. However, physicians have difficulty accurately estimating life expectancy.
Objective: We used data from a population-based observational study to develop a nomogram to estimate long-term other-cause mortality based on self-reported health status (SRHS), race/ethnicity, and age at diagnosis.
Design: This was an observational study.
Subjects: Men diagnosed with localized PCa from October 1994 through October 1995 participated in the study.
Main measures: Initial measures obtained 6 months after diagnosis included sociodemographic and tumor characteristics, treatment, and a single item on the SRHS, with response options ranging from excellent to poor. We used Surveillance, Epidemiology, and End-Results program data to determine date and cause of death through December 2010. We estimated other-cause mortality with proportional hazards survival analyses, accounting for competing risks.
Key results: We evaluated 2,695 men, of whom 74% underwent aggressive therapy (surgery or radiotherapy). At the initial survey, 18% reported excellent (E), 36% very good (VG), 31% good (G), and 15% fair/poor (F/P) health. Healthier men were younger, and more likely to be white, better educated, and to undergo surgery. At follow-up, 44% of the cohort had died; 78% of deaths were from causes other than PCa. SRHS predicted other-cause mortality; for men reporting E, VG, G, F/P health, the cumulative incidences of other-cause mortality were 20%, 29%, 40%, and 53%, respectively, p < 0.001. Compared to a reference of excellent SRHS, multivariable hazard ratios (95% CI) for other-cause mortality for men reporting VG, G, and F/P health were 1.22 (0.97-1.54), 1.73 (1.38-2.17), and 2.71 (2.11-3.48), respectively.
Conclusions: Responses to a one-item SRHS measure were strongly associated with other-cause mortality 15 years after PCa diagnosis. Men reporting fair/poor health had substantial risks for other-cause mortality, suggesting limited benefit for undergoing aggressive treatment. SRHS can be considered in supporting informed decision-making about PCa treatment.
Details
- Title: Subtitle
- Self-Reported Health Status Predicts Other-Cause Mortality in Men with Localized Prostate Cancer: Results from the Prostate Cancer Outcomes Study
- Creators
- Richard M Hoffman - University of New Mexico School of Medicine, Albuquerque, NM 87131 USATatsuki Koyama - Vanderbilt University, Nashville, TN USAPeter C Albertsen - University of Connecticut, Farmington, CT USAMichael J Barry - Harvard Medical School, Boston, MA USATimothy J Daskivich - University of California, Los Angeles, Los Angeles, CA USAMichael Goodman - Emory University, Atlanta, GA USAAnn S Hamilton - Keck School of Medicine, University of Southern California, Los Angeles, CA USAJanet L Stanford - Fred Hutchinson Cancer Research Center, Seattle, WA USAAntoinette M Stroup - University of Utah, Salt Lake City, UT USAArnold L Potosky - Georgetown University, Washington, DC USADavid F Penson - Vanderbilt University, Nashville, TN USA
- Resource Type
- Journal article
- Publication Details
- Journal of general internal medicine : JGIM, Vol.30(7), pp.924-934
- Publisher
- Springer US
- DOI
- 10.1007/s11606-014-3171-8
- PMID
- 25678374
- PMCID
- PMC4471031
- ISSN
- 0884-8734
- eISSN
- 1525-1497
- Language
- English
- Date published
- 07/2015
- Academic Unit
- Epidemiology; General Internal Medicine; Internal Medicine
- Record Identifier
- 9984094583002771
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