Racial differences in survival among men with prostate cancer and comorbidity at time of diagnosis.
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.
Freeman
Vincent L
VL
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
Durazo-Arvizu
Ramon
R
Keys
LaShon C
LC
Johnson
Marc P
MP
Schafernak
Kristian
K
Patel
Vikas K
VK
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