1. Predicting the 10-year risk of death from other causes in men with localized prostate cancer using patient-reported factors: Development of a tool.
- Author
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Frendl DM, FitzGerald G, Epstein MM, Allison JJ, Sokoloff MH, and Ware JE
- Subjects
- Age Factors, Aged, Aged, 80 and over, Comorbidity, Follow-Up Studies, Health Surveys statistics & numerical data, Humans, Life Tables, Male, Marital Status statistics & numerical data, Neoplasm Staging, Prostatic Neoplasms pathology, Risk Assessment methods, Risk Factors, SEER Program statistics & numerical data, Self Report statistics & numerical data, Smoking epidemiology, United States epidemiology, Cause of Death, Models, Statistical, Prostatic Neoplasms epidemiology
- Abstract
Objective: To develop a tool for estimating the 10-year risk of death from other causes in men with localized prostate cancer., Subjects and Methods: We identified 2,425 patients from the Surveillance Epidemiology and End Results-Medicare Health Outcomes Survey database, age <80, newly diagnosed with clinical stage T1-T3a prostate cancer from 1/1/1998-12/31/2009, with follow-up through 2/28/2013. We developed a Fine and Gray competing-risks model for 10-year other cause mortality considering age, patient-reported comorbid medical conditions, component scores and items of the SF-36 Health Survey, activities of daily living, and sociodemographic characteristics. Model discrimination and calibration were compared to predictions from Social Security life table mortality risk estimates., Results: Over a median follow-up of 7.7 years, 76 men died of prostate-specific causes and 465 died of other causes. The strongest predictors of 10-year other cause mortality risk included increasing age at diagnosis, higher approximated Charlson Comorbidity Index score, worse patient-reported general health (fair or poor vs. excellent-good), smoking at diagnosis, and marital status (all other vs. married) (all p<0.05). Model discrimination improved over Social Security life tables (c-index of 0.70 vs. 0.59, respectively). Predictions were more accurate than predictions from the Social Security life tables, which overestimated risk in our population., Conclusions: We provide a tool for estimating the 10-year risk of dying from other causes when making decisions about treating prostate cancer using pre-treatment patient-reported characteristics., Competing Interests: JW received unrestricted research grants from British American Tobacco (Investments) Limited for smoking-related quality of life research which did not fund this work. JW also discloses employment by John Ware Research Group, a commercial company. The other authors have no other competing interests. These disclosures do not alter our adherence to PLOS ONE policies on sharing data and materials. There are no patents, products in development or marketed products associated with this research to declare.
- Published
- 2020
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