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Vincent L. Freeman, MD, MPH, Ramon Durazo-Arvizu, PhD, Ahsan M. Arozullah, MD, MPH and LaShon C. Keys, MEd, RD

Vincent L. Freeman is with the Edward Hines Jr VA Hospital, Hines, Ill. and with the Dept of Medicine and Urology, Loyola University Medical Center, Maywood, Ill. Ramon Durazo-Arvizu is with the Feinberg School of Medicine, Northwestern University, Chicago, Ill. and with the West Side VA Medical Center, Chicago, Ill. Ahsan M. Arozullah is with the University of Illinois at Chicago. LaShon C. Keys is with the Illinois Department of Human Services, Tinley Park.

Correspondence: Requests for reprints should be sent to Vincent L. Freeman, MD, MPH, Edward Hines Jr VA Hospital, PO Box 5000 (151H), Hines, IL 60141 (e-mail: freem595{at}aol.com).

Objectives. We compared patterns of mortality among men with prostate cancer at 2 Department of Veterans Affairs (VA) and 2 private-sector hospitals in the Chicago area.

Methods. Mortality rates for 864 cases diagnosed between 1986 and 1990 were estimated using Cox proportional hazards models that incorporated age; income; cancer stage, differentiation, and treatments; and baseline comorbidity.

Results. Race tended to associate with all-cause mortality irrespective of health care setting (Blacks vs Whites: hazard rate ratio [HRR] = 1.68 [95% confidence interval (CI) = 1.06, 2.67]; P < .001 in the private sector; HRR = 1.50 [95% CI = 0.94, 2.38]; P = .088 in the VA). However, comorbidity determined risk in the VA, whereas age and income predicted risk in the private sector.

Conclusions. Determinants of all-cause mortality in men with prostate cancer vary according to health care setting.

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