Racial differences in the impact of comorbidities on survival among elderly men with prostate cancer

Mary Putt, Judith A. Long, Chantal Montagnet, Jeffrey H. Silber, Virginia W. Chang, Kaijun Liao, J. Sanford Schwartz, Craig Evan Pollack, Yu Ning Wong, Katrina Armstrong

Research output: Contribution to journalArticle

Abstract

This study investigates differences in the effects of comorbidities on survival in Medicare beneficiaries with prostate cancer. Medicare data were used to assemble a cohort of 65- to 76-year-old Black (n = 6,402) and White (n = 47,458) men with incident localized prostate cancer in 1999 who survived ĝ‰¥1 year postdiagnosis. Comorbidities were more prevalent among Blacks than among Whites. For both races, greater comorbidity was associated with decreasing survival rates; however, the effect among Blacks was smaller than in Whites. After adjusting for age, socioeconomic status, and community characteristics, the association between increasing comorbidities and survival remained weaker for Blacks than for Whites, and racial disparity in survival decreased with increasing number of comorbidities. Differential effects of comorbidities on survival were also evident when examining different classes of comorbid conditions. Adjusting for treatment had little impact on these results, despite variation in the racial difference in receipt of prostatectomy with differing comorbidity levels.

Original languageEnglish (US)
Pages (from-to)409-435
Number of pages27
JournalMedical Care Research and Review
Volume66
Issue number4
DOIs
StatePublished - Aug 1 2009

Keywords

  • Administrative data
  • Comorbidity
  • Disparities
  • Medicare
  • Prostate cancer
  • Social epidemiology
  • Survival analysis

ASJC Scopus subject areas

  • Health Policy

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    Putt, M., Long, J. A., Montagnet, C., Silber, J. H., Chang, V. W., Liao, K., Schwartz, J. S., Pollack, C. E., Wong, Y. N., & Armstrong, K. (2009). Racial differences in the impact of comorbidities on survival among elderly men with prostate cancer. Medical Care Research and Review, 66(4), 409-435. https://doi.org/10.1177/1077558709333996