title: Initial treatment for prostate carcinoma in relation to comorbidity and symptoms.
abstract: BACKGROUND
  Evidence suggests the type of treatment received for prostate carcinoma is associated with comorbidity, but little information is available on associations with specific comorbid disease or symptoms. The authors examined the relations between treatment and comorbidity, specific comorbid disease, and symptoms.
  
  
  METHODS
  Medical records were abstracted for 1054 male members of the Kaiser Permanente medical care program diagnosed with prostate carcinoma from 1975 to 1987. Information was obtained on demographic characteristics, comorbid conditions, symptoms, tumor stage and grade, and treatment. Logistic regression was used to determine the significant predictors of treatment (radiation vs. nonaggressive treatment and surgery vs. nonaggressive treatment).
  
  
  RESULTS
  Compared to nonaggressive treatment, radiation treatment was less likely among men who had prior cancer (adjusted odds ratio [OR] 0.29, 95% confidence interval [CI] 0.09-0.90) or cerebrovascular disease (OR 0.33, 95% CI 0.13-0.83). There was a significant interaction between race and myocardial infarction (P = 0.02). Surgery, compared to nonaggressive treatment, was less common among men with a prior cancer (OR 0.21, 95% CI 0.07-0.63) or congestive heart failure (OR 0.29, 95% CI 0.09-0.90). Significant interactions were observed between race and myocardial infarction (P = 0.01), diabetes and dysuria or hematuria (P = 0.02), and para- or hemiplegia and urinary frequency or nocturia (P = 0.01).
  
  
  CONCLUSIONS
  Specific symptoms and comorbidity appear to influence treatment for prostate carcinoma. More research is needed on treatment differences by race.
authors.affiliation: Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. ixhl@cdc.gov
authors.forename: H Irene
authors.initials: HI
authors.lastname: Hall
authors.forename: William A
authors.initials: WA
authors.lastname: Satariano
authors.forename: Trevor
authors.initials: T
authors.lastname: Thompson
authors.forename: Kathleen E
authors.initials: KE
authors.lastname: Ragland
authors.forename: Stephen K
authors.initials: SK
authors.lastname: Van Den Eeden
authors.forename: Steve
authors.initials: S
authors.lastname: Selvin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044383:Black People; D002561:Cerebrovascular Disorders / Q000150:complications; D015897:Comorbidity; D048909:Diabetes Complications; D006333:Heart Failure / Q000150:complications; D006801:Humans; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications; D016017:Odds Ratio; D010347:Patient Care Planning; D011471:Prostatic Neoplasms / Q000150:complications / Q000532:radiotherapy* / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D044465:White People