Department of Population and Quantitative Health Sciences; Department of Surgery; Center for Outcomes Research; Department of Medicine; Meyers Primary Care Institute; Department of Urology
Clinical Epidemiology | Epidemiology | Health Services Administration | Health Services Research | Male Urogenital Diseases | Neoplasms
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.
Cancer risk factors, Prostate cancer, Cancer detection and diagnosis, Cancer treatment, Medical risk factors, Medicare, Epidemiology, Life expectancy
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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
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
Frendl DM, FitzGerald GA, Epstein MM, Allison JJ, Sokoloff MH, Ware JE. (2020). Predicting the 10-year risk of death from other causes in men with localized prostate cancer using patient-reported factors: Development of a tool. Open Access Publications by UMMS Authors. https://doi.org/10.1371/journal.pone.0240039. Retrieved from https://escholarship.umassmed.edu/oapubs/4519
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This work is licensed under a Creative Commons Attribution 4.0 License.