title: Comorbid survival among elderly male participants of the Canada health survey: relevance to prostate cancer screening and treatment.
abstract: This study assessed the survival of a nationally representative sample of older Canadian men, taking into account common comorbid conditions. Mortality follow-up between 1978 and 1989 was conducted for male participants of the Canada Health Survey who were at least 60 years of age at baseline. The proportional hazards model and life table methods were used to examine survival by comorbidity status. Comorbid conditions examined included history of stroke and/or heart disease, high blood pressure, chronic bronchitis or emphysema, diabetes and smoking status, but excluded cancer because of small numbers. For those subjects aged 80 and older, comorbidity was not a significant predictor of survival. A large portion of men between the ages of 60 and 79, even those with pre-existing comorbid conditions, survived at least 10 years after interview. In a clinical setting, more detailed information on comorbid conditions can be obtained to better estimate long-term survival. Notwithstanding, our findings may have implications for the administration of population-based health interventions (e.g. the use of prostate-specific antigen [PSA] blood tests for the early detection of prostate cancer). In particular, our results suggest that there may be little benefit in restricting access to PSA screening based on survival probability in men under age 80.
authors.affiliation: Ottawa Regional Cancer Centre, Ottawa, Ontario, Canada.
authors.forename: L
authors.initials: L
authors.lastname: Eapen
authors.forename: P J
authors.initials: PJ
authors.lastname: Villeneuve
authors.forename: I G
authors.initials: IG
authors.lastname: Levy
authors.forename: H I
authors.initials: HI
authors.lastname: Morrison
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002170:Canada / Q000453:epidemiology; D015897:Comorbidity; D006306:Health Surveys; D006801:Humans; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D009026:Mortality; D016016:Proportional Hazards Models; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000175:diagnosis; D012306:Risk; D012907:Smoking; D015996:Survival Rate
chemical_list: D017430:Prostate-Specific Antigen