For Men With Prostate Cancer, Comorbidities Up Other-Cause Risk
(HealthDay News) – Among men with nonmetastatic prostate cancer the risk for other-cause mortality increases with the number of comorbid conditions, particularly in older men, according to a study published online May 20 in the Annals of Internal Medicine.
Timothy J. Daskivich, MD, from the University of California in Los Angeles, and colleagues examined the effect of age, comorbidity, and tumor risk on prostate cancer-specific and other-cause mortality using data from a nationally representative cohort of 3,183 men with nonmetastatic prostate cancer at diagnosis.
The researchers found that for men with none, one, two, and three or more comorbid conditions, the 14-year cumulative other-cause mortality rates were 24%, 33%, 46%, and 57%, respectively. Subhazard ratios for other-cause mortality were 1.2, 2, and 2.6, respectively, among men diagnosed at age 65 years with one, two, and three or more comorbid conditions (vs. none). For those with three or more comorbid conditions aged ≤60 years, 61–74 years, and ≥75 years or older at diagnosis, 10-year other-cause mortality rates were 26%, 40%, and 71%, respectively. For patients with low-risk and intermediate-risk disease, prostate cancer-specific mortality was minimal (3% and 7%, respectively), but was appreciable for those with high-risk disease (18%). Prostate-cancer specific mortality did not vary by number of comorbid conditions (10–11% in all groups).
"Older men with multiple major comorbid conditions are at high risk for other-cause mortality within 10 years of diagnosis and should consider this information when deciding between conservative management and aggressive treatment for low- or intermediate-risk prostate cancer," the authors write.