UMMS Affiliation

Department of Population and Quantitative Health Sciences; Department of Surgery; Center for Outcomes Research; Department of Medicine; Meyers Primary Care Institute; Department of Urology

Publication Date

2020-12-07

Document Type

Article

Disciplines

Clinical Epidemiology | Epidemiology | Health Services Administration | Health Services Research | Male Urogenital Diseases | Neoplasms

Abstract

OBJECTIVE: To develop a tool for estimating the 10-year risk of death from other causes in men with localized prostate cancer.

SUBJECTS AND METHODS: We identified 2,425 patients from the Surveillance Epidemiology and End Results-Medicare Health Outcomes Survey database, age < 80, newly diagnosed with clinical stage T1-T3a prostate cancer from 1/1/1998-12/31/2009, with follow-up through 2/28/2013. We developed a Fine and Gray competing-risks model for 10-year other cause mortality considering age, patient-reported comorbid medical conditions, component scores and items of the SF-36 Health Survey, activities of daily living, and sociodemographic characteristics. Model discrimination and calibration were compared to predictions from Social Security life table mortality risk estimates.

RESULTS: Over a median follow-up of 7.7 years, 76 men died of prostate-specific causes and 465 died of other causes. The strongest predictors of 10-year other cause mortality risk included increasing age at diagnosis, higher approximated Charlson Comorbidity Index score, worse patient-reported general health (fair or poor vs. excellent-good), smoking at diagnosis, and marital status (all other vs. married) (all p < 0.05). Model discrimination improved over Social Security life tables (c-index of 0.70 vs. 0.59, respectively). Predictions were more accurate than predictions from the Social Security life tables, which overestimated risk in our population.

CONCLUSIONS: We provide a tool for estimating the 10-year risk of dying from other causes when making decisions about treating prostate cancer using pre-treatment patient-reported characteristics.

Keywords

Cancer risk factors, Prostate cancer, Cancer detection and diagnosis, Cancer treatment, Medical risk factors, Medicare, Epidemiology, Life expectancy

Rights and Permissions

Copyright: © 2020 Frendl et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

DOI of Published Version

10.1371/journal.pone.0240039

Source

Frendl DM, FitzGerald G, Epstein MM, Allison JJ, Sokoloff MH, Ware JE. Predicting the 10-year risk of death from other causes in men with localized prostate cancer using patient-reported factors: Development of a tool. PLoS One. 2020 Dec 7;15(12):e0240039. doi: 10.1371/journal.pone.0240039. PMID: 33284845; PMCID: PMC7721137. Link to article on publisher's site

Journal/Book/Conference Title

PloS one

Related Resources

Link to Article in PubMed

PubMed ID

33284845

Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.

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