Life tables adjusted for comorbidity more accurately estimate noncancer survival for recently diagnosed cancer patients
Life tables adjusted for comorbidity more accurately estimate noncancer survival for recently diagnosed cancer patients
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DOI：
10.1016/j.jclinepi.2013.07.002
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发表时间：
2013-12-01
影响因子：
7.2
通讯作者：
Feuer, Eric J.
中科院分区：
文献类型：
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作者：
Mariotto, Angela B.;Wang, Zhuoqiao;Feuer, Eric J.
目的：为了给癌症患者和临床医生提供关于非癌症死亡率的更准确的患者预期寿命估计，我们估计了合并症调整生命表和健康调整年龄。研究设计和设置：使用来自监测流行病学和最终结果医疗保险数据库的数据，我们估计了反映66岁及以上患者在癌症诊断前一年健康状况的合并症评分。通过合并症评分对不同年龄、种族和性别的非癌生存率进行估计。通过系统地比较非癌症生存模型和美国生命表来估计健康调整年龄。结果：合并症、癌症状态、性别和种族都是非癌症生存的重要预测因素；然而，随着年龄的增长，它们对非癌症生存的相对影响会降低。共病生存模型比美国生命表更能预测非癌症生存。可以查阅健康调整年龄表和国家生命表，以提供一个人的预期寿命的大致估计，例如，一名75岁无合并症的黑人的健康调整年龄为67岁，他的预期寿命为13年。结论：健康调整年龄和按年龄、种族、性别和合并症调整的生命表可以为癌症和其他疾病的治疗决策提供重要信息。Elsevier Inc.出版。
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. Published by Elsevier Inc.