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Showing content from https://pubmed.ncbi.nlm.nih.gov/24035494/ below:

Life tables adjusted for comorbidity more accurately estimate noncancer survival for recently diagnosed cancer patients

Affiliations

• ¹ Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD 20892, USA. Electronic address: mariotta@mail.nih.gov.

• PMID: 24035494
• PMCID: PMC3934002
• DOI: 10.1016/j.jclinepi.2013.07.002

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Angela B Mariotto et al. J Clin Epidemiol. 2013 Dec.

• ¹ Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD 20892, USA. Electronic address: mariotta@mail.nih.gov.

• PMID: 24035494
• PMCID: PMC3934002
• DOI: 10.1016/j.jclinepi.2013.07.002

Item in Clipboard

Objectives: To provide cancer patients and clinicians with more accurate estimates of a patient's life expectancy with respect to noncancer mortality, we estimated comorbidity-adjusted life tables and health-adjusted age.

Study design and setting: Using data from the Surveillance Epidemiology and End Results-Medicare database, we estimated comorbidity scores that reflect the health status of people who are 66 years of age and older in the year before cancer diagnosis. Noncancer survival by comorbidity score was estimated for each age, race, and sex. Health-adjusted age was estimated by systematically comparing the noncancer survival models with US life tables.

Results: Comorbidity, cancer status, sex, and race are all important predictors of noncancer survival; however, their relative impact on noncancer survival decreases as age increases. Survival models by comorbidity better predicted noncancer survival than the US life tables. The health-adjusted age and national life tables can be consulted to provide an approximate estimate of a person's life expectancy, for example, the health-adjusted age of a black man aged 75 years with no comorbidities is 67 years, giving him a life expectancy of 13 years.

Conclusion: The health-adjusted age and the life tables adjusted by age, race, sex, and comorbidity can provide important information to facilitate decision making about treatment for cancer and other conditions.

Keywords: Cancer; Comorbidity; Health-adjusted age; Life expectancy; Life tables; SEER–Medicare; Survival.

Published by Elsevier Inc.

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Relative risk of dying of…

Relative risk of dying of other causes of death by comorbidity score for…

Relative risk of dying of other causes of death by comorbidity score for selected ages. Reference category is people with no comorbidity (comorbidity score 0). Estimates from the Cox proportional hazard model are fitted to people without cancer from the non-cancer sample of Medicare beneficiaries residing in the SEER areas (1992–2005).

Fit of estimated net other-cause…

Fit of estimated net other-cause survival for white women diagnosed with cancer at…

Fit of estimated net other-cause survival for white women diagnosed with cancer at 70 years old and selected comorbidity scores (plain lines) to the best-fit US life table (dashed lines). The age of the best-fit US life table is the health-adjusted age corresponding to a 70-year-old female white cancer patient with the given comorbidity.

AUC against survival time at…

AUC against survival time at follow-up for male and female cancer patients by…

AUC against survival time at follow-up for male and female cancer patients by age at diagnosis (66 to 90).

AUC against survival time at…

AUC against survival time at follow-up for male and female cancer patients by…

AUC against survival time at follow-up for male and female cancer patients by age at diagnosis (66 to 90).

Average probability of surviving non-cancer…

Average probability of surviving non-cancer death for cancer patients diagnosed by years since…

Average probability of surviving non-cancer death for cancer patients diagnosed by years since diagnosis. Cancer patients diagnosed at age 66 with no comorbidity and comorbidity scores between 0.5 and 1.0 by race and sex. Modeled (red lines), observed and 95% confidence intervals (green lines), estimated using 2000 US life tables (blue lines). Figures are by sex and by race. A. Age 66 and No comorbidity B. Age 66 and Comorbidity score between 0.5 and 1.0

Average probability of surviving non-cancer…

Average probability of surviving non-cancer death for cancer patients diagnosed by years since…

Average probability of surviving non-cancer death for cancer patients diagnosed by years since diagnosis. Cancer patients diagnosed at age 66 with no comorbidity and comorbidity scores between 0.5 and 1.0 by race and sex. Modeled (red lines), observed and 95% confidence intervals (green lines), estimated using 2000 US life tables (blue lines). Figures are by sex and by race. A. Age 66 and No comorbidity B. Age 66 and Comorbidity score between 0.5 and 1.0

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