title: Comorbidity independently predicted death in older prostate cancer patients, more of whom died with than from their disease.
abstract: OBJECTIVE
  The purpose of this study was to examine the proportion of men who died from prostate cancer (PrCa) vs. with PrCa and assess the comorbid conditions associated with other-cause deaths.
  
  
  METHODS
  We identified all male decedents aged >/=65 years in Jefferson County, AL, in 1993-1995. By crosslinking three databases (death certificate, Medicare, and Veteran's Administration), we identified men whose deaths might have been caused by PrCa. We abstracted and reviewed medical records to rate comorbid conditions and determine whether or not death was due to PrCa.
  
  
  RESULTS
  Of 561 men with a premortem diagnosis of PrCa, 42% died from PrCa and 53% died with PrCA; 50.2% of blacks died from PrCa vs. 36.9% of Whites. Other factors related to dying with PrCa included older age at death and a serious, or very serious, comorbid condition. Treatment did not have an independent effect on cause of death (i.e., death with vs. from PrCa).
  
  
  CONCLUSIONS
  Comorbidity was an independent predictor of dying with PrCa, even after adjustment for ethnicity, age, and treatment. Given the as yet unproven benefit of PrCa screening, our results extend the body of information relevant to the screening decision; among men dying with a diagnosis of PrCa, only about 1/3 to 1/2 died from the disease.
authors.affiliation: Division of Preventive Medicine, University of Alabama at Birmingham, 1530 3rd Avenue South, MT 618, Birmingham, AL 35294-4410, USA. mfouad@mail.dopm.uab.edu
authors.forename: Mona N
authors.initials: MN
authors.lastname: Fouad
authors.forename: Charlotte P
authors.initials: CP
authors.lastname: Mayo
authors.forename: Ellen M
authors.initials: EM
authors.lastname: Funkhouser
authors.forename: H
authors.initials: H
authors.lastname: Irene Hall
authors.forename: Donald A
authors.initials: DA
authors.lastname: Urban
authors.forename: Catarina I
authors.initials: CI
authors.lastname: Kiefe
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000407:Alabama / Q000453:epidemiology; D044383:Black People / Q000706:statistics & numerical data; D002318:Cardiovascular Diseases / Q000401:mortality; D002423:Cause of Death; D015897:Comorbidity; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000401:mortality; D011471:Prostatic Neoplasms / Q000401:mortality*; D029424:Pulmonary Disease, Chronic Obstructive / Q000401:mortality; D012189:Retrospective Studies; D012720:Severity of Illness Index; D044465:White People / Q000706:statistics & numerical data; D001741:Black or African American