Co-morbidity in patients with prostate cancer and its impact on mortality in black and white men

Objectives: Previous studies have demonstrated that co-morbidity is related to poorer survival among patients with prostate cancer. We evaluated aspects of co-morbidity in patients who died from prostate cancer as compared to hospital controls.

Methods: Using retrospective case-control hospital-based methodology, we compared 404 prostate cancer patients to 404 age/race frequency-matched controls. Cases were identified through 1998-2001 death certificates and medical records abstracts gathered in Atlanta and North Florida hospitals. Racial and age-specific differences in the level of co-morbidity were computed. Logistic regression was used to measure their impact on mortality.

Results: Cases had more co-morbidities (10.33 vs. 2.63; p<.05), except for stroke (1.5 vs. 12.6; p <.05) and cardiovascular disease (no difference). Cases had more co-morbidity within both races (11.16 vs. 2.83 whites; 9.03 vs. 2.35 blacks). However, white cases had slightly more, but significant number of co-morbidities compared to blacks (11.16 vs. 9.03; p=.044). Both younger (50-64 years) and older adults (65 years or older) had higher level of co-morbidity among the cases. Co-morbidity was a strong predictor of the risk of death from prostate cancer, independent of age. Logistic regression showed that the odds of dying increase by 15% for each additional co-morbid condition.

Conclusion: Results indicated that persons that died from prostate cancer have more co-morbidities than persons that did not die from prostate cancer. There were differences in disease-specific co-morbidities between cases and controls, indicating that persons that die from prostate cancer have a heavier disease burden than persons that did not die from prostate cancer.