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Comparative Study
. 2003 Oct;93(10):1706-12.
doi: 10.2105/ajph.93.10.1706.

Determinants of mortality following a diagnosis of prostate cancer in Veterans Affairs and private sector health care systems

Vincent L Freeman  1 , Ramon Durazo-Arvizu, Ahsan M Arozullah, LaShon C Keys
Affiliations
Comparative Study

Determinants of mortality following a diagnosis of prostate cancer in Veterans Affairs and private sector health care systems

Vincent L Freeman et al. Am J Public Health. 2003 Oct.

Abstract

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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Figures

FIGURE 1—
FIGURE 1—
Kaplan–Meier survival distributions by race and by comorbidity level.
FIGURE 2—
FIGURE 2—
Bootstrap confidence intervals for all-cause mortality rates of Blacks relative to Whites, by Charlson comorbidity score. Note. VA = Department of Veterans Affairs. Estimates are adjusted for age, tumor stage, tumor differentiation, and treatment. *P < .05.
See this image and copyright information in PMC

References

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