title: Racial differences in survival among men with prostate cancer and comorbidity at time of diagnosis.
abstract: OBJECTIVE
  This study evaluated the effect of comorbidity at diagnosis on racial differences in survival among men with prostate cancer.
  
  
  METHODS
  Clinical and demographic data were abstracted from records of 864 patients diagnosed at 4 Chicago area hospitals between 1986 and 1990. Comorbidity was scored on the basis of clinical information in the Charlson index. Cause-specific relative mortality adjusted for age, stage, differentiation, and treatment was compared across Charlson scores with Cox proportional hazards functions.
  
  
  RESULTS
  Blacks had significantly greater mortality from prostate cancer and other causes (vs Whites, relative risk [95% confidence interval] = 1.84 [1.22, 2.79] and 1.69 [1.33, 2.29], respectively; P <.001). However, differences disappeared as initial comorbidity increased (1.75 [1.33, 2.31] vs 0.90 [0.59, 1.29] for scores = 0 and > or =5, respectively).
  
  
  CONCLUSIONS
  Absence of a significant preexisting medical diagnosis is associated with a higher risk for excess mortality among Black men diagnosed with prostate cancer.
authors.affiliation: Midwest Center for Health Services and Policy Research, Edward Hines Jr. VA Hospital, PO Box 5000 (151 H), Hines, IL 60141, USA. freeman@research.hines.med.va.gov
authors.forename: Vincent L
authors.initials: VL
authors.lastname: Freeman
authors.forename: Ramon
authors.initials: R
authors.lastname: Durazo-Arvizu
authors.forename: LaShon C
authors.initials: LC
authors.lastname: Keys
authors.forename: Marc P
authors.initials: MP
authors.lastname: Johnson
authors.forename: Kristian
authors.initials: K
authors.lastname: Schafernak
authors.forename: Vikas K
authors.initials: VK
authors.lastname: Patel
mesh_terms: D000230:Adenocarcinoma / Q000208:ethnology* / Q000401:mortality*; D000368:Aged; D044383:Black People; D016009:Chi-Square Distribution; D002641:Chicago / Q000453:epidemiology; D015897:Comorbidity; D006801:Humans; D008297:Male; D016016:Proportional Hazards Models; D011471:Prostatic Neoplasms / Q000208:ethnology* / Q000401:mortality*; D015996:Survival Rate; D044465:White People; D001741:Black or African American