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Vincent L. Freeman, MD, MPH, Ramon Durazo-Arvizu, PhD, LaShon C. Keys, MEd, RD, Marc P. Johnson, BA, Kristian Schafernak, MD, MPH and Vikas K. Patel, MD

Vincent L. Freeman is with the Midwest Center for Health Services and Policy Research, Edward Hines Jr. VA Hospital, Hines, Ill. Vincent L. Freeman, Marc P. Johnson, Kristian Schafernak, and Vikas K. Patel are with the Department of Medicine, Loyola University Stritch School of Medicine, Maywood, Ill. Ramon Durazo-Arvizu is with the Department of Medicine, The Feinberg School of Medicine, Northwestern University, Chicago, Ill. LaShon C. Keys is with the Division of Community Health and Prevention, Illinois Department of Human Services, Tinley Park, Ill.

Correspondence: Requests for reprints should be sent to Vincent L. Freeman, MD, MPH, Midwest Center for Health Services and Policy Research, Edward Hines Jr. VA Hospital, PO Box 5000 (151 H), Hines, IL 60141 (e-mail: freeman{at}research.hines.med.va.gov).

Objectives. This study evaluated the effect of comorbidity at diagnosis on racial differences in survival among men with prostate cancer.

Methods. Clinical and demographic data were abstracted from records of 864 patients diagnosed at 4 Chicago area hospitals between 1986 and 1990. Comorbidity was scored on the basis of clinical information in the Charlson index. Cause-specific relative mortality adjusted for age, stage, differentiation, and treatment was compared across Charlson scores with Cox proportional hazards functions.

Results. Blacks had significantly greater mortality from prostate cancer and other causes (vs Whites, relative risk [95% confidence interval] = 1.84 [1.22, 2.79] and 1.69 [1.33, 2.29], respectively; P < .001). However, differences disappeared as initial comorbidity increased (1.75 [1.33, 2.31] vs 0.90 [0.59, 1.29] for scores = 0 and 5, respectively).

Conclusions. Absence of a significant preexisting medical diagnosis is associated with a higher risk for excess mortality among Black men diagnosed with prostate cancer.

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				A. S. Robbins, D. Yin, and A. Parikh-Patel Differences in Prognostic Factors and Survival among White Men and Black Men with Prostate Cancer, California, 1995-2004 Am. J. Epidemiol., July 1, 2007; 166(1): 71 - 78. [Abstract] [Full Text] [PDF]