Initial treatment for prostate carcinoma in relation to comorbidity and symptoms

Authors

  • H. Irene Hall Ph.D., B.S.,

    Corresponding author
    1. Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
    • Centers for Disease Control and Prevention, NCHSTP/DHAP, 1600 Clifton Rd. NE, Mailstop E-47, Atlanta, GA 30333
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    • Fax: (404) 639-2980

  • William A. Satariano Ph.D., M.P.H.,

    1. Division of Public Health Biology and Epidemiology, School of Public Health, University of California at Berkeley, Berkeley, California
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  • Trevor Thompson B.S.,

    1. Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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  • Kathleen E. Ragland Ph.D.,

    1. Center for Family and Community Health, School of Public Health, University of California at Berkeley, Berkeley, California
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  • Stephen K. Van Den Eeden Ph.D.,

    1. Division of Research, Kaiser Permanente, Oakland, California
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  • Steve Selvin Ph.D.

    1. Division of Biostatistics and Information Sciences, School of Public Health, University of California at Berkeley, Berkeley, California
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  • This article is a US Government work and, as such, is in the public domain in the United States of America.

  • Data collection supported by a cooperative agreement (U48/CCU909706) between the Centers for Disease Control and Prevention and the Center for Family and Community Health at the University of California, Berkeley.

Abstract

BACKGROUND

Evidence suggests the type of treatment received for prostate carcinoma is associated with comorbidity, but little information is available on associations with specific comorbid disease or symptoms. The authors examined the relations between treatment and comorbidity, specific comorbid disease, and symptoms.

METHODS

Medical records were abstracted for 1054 male members of the Kaiser Permanente medical care program diagnosed with prostate carcinoma from 1975 to 1987. Information was obtained on demographic characteristics, comorbid conditions, symptoms, tumor stage and grade, and treatment. Logistic regression was used to determine the significant predictors of treatment (radiation vs. nonaggressive treatment and surgery vs. nonaggressive treatment).

RESULTS

Compared to nonaggressive treatment, radiation treatment was less likely among men who had prior cancer (adjusted odds ratio [OR] 0.29, 95% confidence interval [CI] 0.09–0.90) or cerebrovascular disease (OR 0.33, 95% CI 0.13–0.83). There was a significant interaction between race and myocardial infarction (P = 0.02). Surgery, compared to nonaggressive treatment, was less common among men with a prior cancer (OR 0.21, 95% CI 0.07–0.63) or congestive heart failure (OR 0.29, 95% CI 0.09–0.90). Significant interactions were observed between race and myocardial infarction (P = 0.01), diabetes and dysuria or hematuria (P = 0.02), and para- or hemiplegia and urinary frequency or nocturia (P = 0.01).

CONCLUSIONS

Specific symptoms and comorbidity appear to influence treatment for prostate carcinoma. More research is needed on treatment differences by race. Cancer 2002;95:2308–15. Published 2002 by the American Cancer Society.

DOI 10.1002/cncr.10926

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