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

Am J Public Health. 2003 Oct;93(10):1706-12. doi: 10.2105/ajph.93.10.1706.

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.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • African Americans / statistics & numerical data*
  • Aged
  • Chicago / epidemiology
  • Cohort Studies
  • Comorbidity
  • European Continental Ancestry Group / statistics & numerical data*
  • Health Behavior / ethnology
  • Health Services Accessibility
  • Hospital Mortality*
  • Hospitals, Private / statistics & numerical data*
  • Hospitals, University / statistics & numerical data*
  • Hospitals, Veterans / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • Practice Patterns, Physicians'
  • Proportional Hazards Models
  • Prostatic Neoplasms / ethnology*
  • Prostatic Neoplasms / mortality*
  • Retrospective Studies
  • Socioeconomic Factors
  • Survival Analysis