TY - JOUR
T1 - Impact of comorbidities on prostate cancer-specific mortality
T2 - A population-based cohort study
AU - Tiruye, Tenaw
AU - Roder, David
AU - FitzGerald, Liesel M.
AU - O'Callaghan, Michael
AU - Moretti, Kim
AU - Caughey, Gillian E.
AU - Beckmann, Kerri
N1 - Publisher Copyright:
© 2024 The Author(s). The Prostate published by Wiley Periodicals LLC.
PY - 2024
Y1 - 2024
N2 - Aim: To assess the impact of comorbidities on prostate cancer mortality. Methods: We studied 15,695 South Australian men diagnosed with prostate cancer between 2003 and 2019 from state-wide administrative linked data sets. Comorbidity was measured 1-year before prostate cancer diagnosis using Rx-Risk, a medication-based comorbidity index. Flexible parametric competing risk regression was used to estimate the independent association between comorbidities and prostate cancer-specific mortality. Specific common comorbidities within Rx-Risk (cardiac disorders, diabetes, chronic airway diseases, depression and anxiety, thrombosis, and pain) were also assessed to determine their association with mortality. All models were adjusted for sociodemographic variables, tumor characteristics, and treatment type. Results: Prostate cancer-specific mortality was higher for patients with a Rx-Risk score ≥3 versus 0 (adjusted sub-hazard ratio (sHR) 1.34, 95% CI: 1.15–1.56). Lower comorbidity scores (Rx-Risk score 2 vs. 0 and Rx-Risk score 1 vs. 0) were not significantly associated with prostate cancer-specific mortality. Men who were using medications for cardiac disorders (sHR 1.31, 95% CI: 1.13–1.52), chronic airway disease (sHR 1.20, 95% CI: 1.01–1.44), depression and anxiety (sHR 1.17, 95% CI: 1.02–1.35), and thrombosis (sHR 1.21, 95% CI: 1.04–1.42) were at increased risk of dying from prostate cancer compared with men not on those medications. Use of medications for diabetes and chronic pain were not associated with prostate cancer-specific mortality. All Rx-Risk score categories and the specific comorbidities were also associated with increased risk of all-cause mortality. Conclusion: The findings showed that ≥3 comorbid conditions and specific comorbidities including cardiac disease, chronic airway disease, depression and anxiety, and thrombosis were associated with poor prostate cancer-specific survival. Appropriate management of these comorbidities may help to improve survival in prostate cancer patients.
AB - Aim: To assess the impact of comorbidities on prostate cancer mortality. Methods: We studied 15,695 South Australian men diagnosed with prostate cancer between 2003 and 2019 from state-wide administrative linked data sets. Comorbidity was measured 1-year before prostate cancer diagnosis using Rx-Risk, a medication-based comorbidity index. Flexible parametric competing risk regression was used to estimate the independent association between comorbidities and prostate cancer-specific mortality. Specific common comorbidities within Rx-Risk (cardiac disorders, diabetes, chronic airway diseases, depression and anxiety, thrombosis, and pain) were also assessed to determine their association with mortality. All models were adjusted for sociodemographic variables, tumor characteristics, and treatment type. Results: Prostate cancer-specific mortality was higher for patients with a Rx-Risk score ≥3 versus 0 (adjusted sub-hazard ratio (sHR) 1.34, 95% CI: 1.15–1.56). Lower comorbidity scores (Rx-Risk score 2 vs. 0 and Rx-Risk score 1 vs. 0) were not significantly associated with prostate cancer-specific mortality. Men who were using medications for cardiac disorders (sHR 1.31, 95% CI: 1.13–1.52), chronic airway disease (sHR 1.20, 95% CI: 1.01–1.44), depression and anxiety (sHR 1.17, 95% CI: 1.02–1.35), and thrombosis (sHR 1.21, 95% CI: 1.04–1.42) were at increased risk of dying from prostate cancer compared with men not on those medications. Use of medications for diabetes and chronic pain were not associated with prostate cancer-specific mortality. All Rx-Risk score categories and the specific comorbidities were also associated with increased risk of all-cause mortality. Conclusion: The findings showed that ≥3 comorbid conditions and specific comorbidities including cardiac disease, chronic airway disease, depression and anxiety, and thrombosis were associated with poor prostate cancer-specific survival. Appropriate management of these comorbidities may help to improve survival in prostate cancer patients.
KW - comorbidity
KW - mortality
KW - prostate cancer
UR - http://www.scopus.com/inward/record.url?scp=85194461517&partnerID=8YFLogxK
U2 - 10.1002/pros.24750
DO - 10.1002/pros.24750
M3 - Article
C2 - 38798040
AN - SCOPUS:85194461517
SN - 0270-4137
JO - Prostate
JF - Prostate
ER -