Effect of Age, Tumor Risk, and Comorbidity in a U.S. Population–Based Cohort of Men With Prostate Cancer
Authors: Timothy J. Daskivich, Mark S. Litwin, David F. Penson
Journal: Annals of Internal Medicine (2013)

LettersSeptember 3, 2013Effect of Age, Tumor Risk, and Comorbidity in a U.S. Population–Based Cohort of Men With Prostate CancerTimothy J. Daskivich, MD, Mark S. Litwin, MD, MPH, and David F. Penson, MD, MPHTimothy J. Daskivich, MDFrom University of California, Los Angeles, Los Angeles, California; and Vanderbilt University Medical Center, Nashville, Tennessee., Mark S. Litwin, MD, MPHFrom University of California, Los Angeles, Los Angeles, California; and Vanderbilt University Medical Center, Nashville, Tennessee., and David F. Penson, MD, MPHFrom University of California, Los Angeles, Los Angeles, California; and Vanderbilt University Medical Center, Nashville, Tennessee.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-159-5-201309030-00018 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Determining long-term mortality outcomes using a population that is preselected to be the healthiest for surgery (what Dr. Froehner and coworkers are suggesting) incurs selection bias that drastically overestimates survival for the average person. This phenomenon has been shown previously in other literature (1). Although we agree that some older men with multiple comorbid conditions may be unusually fit and may have sufficient longevity to benefit from treatment, it is disingenuous to generalize these outliers to a broader population considering treatment. We believe that our population-based estimates of 10-year mortality by age and comorbid conditions, which are consistent ...References1. Tewari A, Johnson CC, Divine G, Crawford ED, Gamito EJ, Demers R, et al. Long-term survival probability in men with clinically localized prostate cancer: a case-control, propensity modeling study stratified by race, age, treatment and comorbidities. J Urol. 2004;171:1513-9. [PMID: 15017210] CrossrefMedlineGoogle Scholar2. Berglund A, Garmo H, Tishelman C, Holmberg L, Stattin P, and Lambe M. Comorbidity, treatment and mortality: a population based cohort study of prostate cancer in PCBaSe Sweden. J Urol. 2011;185:833-9. [PMID: 21239002] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Timothy J. Daskivich, MD; Mark S. Litwin, MD, MPH; David F. Penson, MD, MPHAffiliations: From University of California, Los Angeles, Los Angeles, California; and Vanderbilt University Medical Center, Nashville, Tennessee.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M12-1703. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoEffect of Age, Tumor Risk, and Comorbidity on Competing Risks for Survival in a U.S. Population–Based Cohort of Men With Prostate Cancer Timothy J. Daskivich , Kang-Hsien Fan , Tatsuki Koyama , Peter C. Albertsen , Michael Goodman , Ann S. Hamilton , Richard M. Hoffman , Janet L. Stanford , Antoinette M. Stroup , Mark S. Litwin , and David F. Penson Effect of Age, Tumor Risk, and Comorbidity in a U.S. Population–Based Cohort of Men With Prostate Cancer Michael Froehner , Rainer Koch , and Manfred P. Wirth Metrics September 3, 2013Volume 159, Issue 5Page: 370KeywordsCancer treatmentCohort studiesProstate cancerSurgery ePublished: 3 September 2013 Issue Published: September 3, 2013 Copyright & PermissionsCopyright © 2013 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...