Predicting the 10-year risk of death from other causes in men with localized prostate cancer using patient-reported factors: Development of a tool

• Published in: PloS one Vol. 15; no. 12; p. e0240039
• Main Authors: Frendl, Daniel M., FitzGerald, Gordon, Epstein, Mara M., Allison, Jeroan J., Sokoloff, Mitchell H., Ware, John E.
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 07.12.2020; Public Library of Science (PLoS)
• Subjects: Activities of daily living; Age; Age Factors; Aged; Aged, 80 and over; Arthritis; Biology and Life Sciences; Calibration; Cardiovascular disease; Care and treatment; Cause of Death; Chronic obstructive pulmonary disease; Comorbidity; Death & dying; Development and progression; Diagnosis; Education; Epidemiology; Estimation; Evaluation; Follow-Up Studies; Forecasts and trends; Government programs; Health risk assessment; Health risks; Health sciences; Health surveys; Health Surveys - statistics & numerical data; Hispanic people; Humans; Life expectancy; Life Tables; Male; Marital Status - statistics & numerical data; Medical diagnosis; Medical schools; Medicare; Medicine and Health Sciences; Models, Statistical; Mortality; Mortality risk; Neoplasm Staging; Patients; Polls & surveys; Predictions; Prostate cancer; Prostatic Neoplasms - epidemiology; Prostatic Neoplasms - pathology; Risk; Risk Assessment - methods; Risk Factors; SEER Program - statistics & numerical data; Self Report - statistics & numerical data; Smoking - epidemiology; Social interactions; Social Sciences; Social security; Tables (data); Tumors; United States; United States - epidemiology; Urology; United States; United States > US
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0240039

To develop a tool for estimating the 10-year risk of death from other causes in men with localized prostate cancer. 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. 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. 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.