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Self-rated health as a tool for estimating health-adjusted life expectancy among patients newly diagnosed with localized prostate cancer: a preliminary study

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Abstract

Purpose

Localized prostate cancer (LPC) patients are faced with numerous treatment options, including observation or watchful waiting. The choice of treatment largely depends on their baseline health-adjusted life expectancy (HALE). By consensus, physicians recommend treatment if the patient’s HALE is ten or more years. However, the estimation of HALE is difficult. Although subjective by nature, self-rated health (SRH) is a robust predictor of mortality. We studied the usefulness of SRH in estimating HALE in patients who are considering treatment for LPC.

Methods

A total of 144 LPC patients from a large urology private practice in Norfolk, Virginia, were surveyed before they had chosen a treatment option.

Results

HALE determined by SRH correlated well with objective health measures and was higher than age-based life expectancy by an average of 2 years. The observed difference in life expectancy due to SRH adjustment was higher among patients with a better socioeconomic and health profile.

Conclusions

SRH is an easy-to-use indicator of HALE in LPC patients. A table for HALE estimation by age and SRH is provided for men aged 70–80 years. Additional research with larger samples and prospective study designs are needed before the SRH method can be used in primary care and urology settings.

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Abbreviations

BRFSS:

Behavioral Risk Factor Surveillance Systems

CCI:

Charlson comorbidity index

CDC:

Centers for Disease Control and Prevention

DASI:

Duke Activity Status Index

HAD:

Hospital Anxiety and Depression

HALE:

Health-adjusted life expectancy

HRQOL:

Health-related quality of life

LPC:

Localized prostate cancer

METS:

Metabolic Equivalents

MOS-SSS:

Medical Outcomes Study Social Support Scale

NCCN:

National Comprehensive Cancer Network

PSA:

Prostate-specific antigen

SRH:

Self-rated health

NHANES:

National Health and Nutrition Examination Surveys

References

  1. Harlan, S. R., Cooperberg, M. R., Elkin, E. P., Lubeck, D. P., Meng, M. V., Mehta, S. S., et al. (2003). Time trends and characteristics of men choosing watchful waiting for initial treatment of localized prostate cancer: Results from CaPSURE. The Journal of urology, 170(5), 1804–1807.

    Article  PubMed  Google Scholar 

  2. Parker, C., Muston, D., Melia, J., Moss, S., & Dearnaley, D. (2006). A model of the natural history of screen-detected prostate cancer, and the effect of radical treatment on overall survival. British Journal of Cancer, 94(10), 1361–1368.

    Article  PubMed  CAS  Google Scholar 

  3. Wilson, J. R., Clarke, M. G., Ewings, P., Graham, J. D., & MacDonagh, R. (2005). The assessment of patient life-expectancy: How accurate are urologists and oncologists? BJU International, 95(6), 794–798.

    Article  PubMed  Google Scholar 

  4. Taichman, R. S., Loberg, R. D., Mehra, R., & Pienta, K. J. (2007). The evolving biology and treatment of prostate cancer. The Journal of Clinical Investigation, 117(9), 2351–2361.

    Article  PubMed  CAS  Google Scholar 

  5. Jemal, A., Siegel, R., Ward, E., Murray, T., Xu, J., & Thun, M. J. (2007). Cancer statistics, 2007. CA: A Cancer Journal for Clinicians, 57(1), 43–66.

    Article  Google Scholar 

  6. Klotz, L. (2005). Active surveillance for prostate cancer: For whom? Journal of Clinical Oncology, 23(32), 8165–8169.

    Article  PubMed  Google Scholar 

  7. Post, P. N., Hansen, B. E., Kil, P. J., Janssen-Heijnen, M. L., & Coebergh, J. W. (2001). The independent prognostic value of comorbidity among men aged <75 years with localized prostate cancer: A population-based study. BJU International, 87(9), 821–826.

    Article  PubMed  CAS  Google Scholar 

  8. van den Bergh, R. C., Roemeling, S., Roobol, M. J., Aus, G., Hugosson, J., Rannikko, A. S., Tammela, T. L., Bangma, C. H., & Schroder, F. H. (2008). Outcomes of men with screen-detected prostate cancer eligible for active surveillance who were managed expectantly. European Urology.

  9. Ruchlin, H. S., & Pellissier, J. M. (2001). An economic overview of prostate carcinoma. Cancer, 92(11), 2796–2810.

    Article  PubMed  CAS  Google Scholar 

  10. Miller, D. C., Gruber, S. B., Hollenbeck, B. K., Montie, J. E., & Wei, J. T. (2006). Incidence of initial local therapy among men with lower-risk prostate cancer in the United States. Journal of the National Cancer Institute, 98(16), 1134–1141.

    Article  PubMed  Google Scholar 

  11. Dahm, P., Kunz, R., & Schunemann, H. (2007). Evidence-based clinical practice guidelines for prostate cancer: The need for a unified approach. Current Opinion in Urology, 17(3), 200–207.

    Article  PubMed  Google Scholar 

  12. McCloskey, S. A., & Kuettel, M. R. (2007). Counterpoint: Prostate cancer life expectancy can not be accurately predicted from currently available tools. Journal of the National Comprehensive Cancer Network, 5(7), 709–713.

    PubMed  Google Scholar 

  13. Kistler, C. E., Lewis, C. L., Amick, H. R., Bynum, D. L., Walter, L. C., & Watson, L. C. (2006). Older adults’ beliefs about physician-estimated life expectancy: A cross-sectional survey. BMC Family Practice, 7, 9.

    Article  PubMed  Google Scholar 

  14. Walz, J., Gallina, A., Hutterer, G., Perrotte, P., Shariat, S. F., Graefen, M., et al. (2007). Accuracy of life tables in predicting overall survival in candidates for radiotherapy for prostate cancer. International Journal of Radiation Oncology, Biology, Physics, 69(1), 88–94.

    Article  PubMed  Google Scholar 

  15. Walter, L. C., & Covinsky, K. E. (2001). Cancer screening in elderly patients: A framework for individualized decision making. JAMA, 285(21), 2750–2756.

    Article  PubMed  CAS  Google Scholar 

  16. Cohen, H., & Britten, N. (2003). Who decides about prostate cancer treatment? A qualitative study. Family Practice, 20(6), 724–729.

    Article  PubMed  Google Scholar 

  17. Welch, H. G., Albertsen, P. C., Nease, R. F., Bubolz, T. A., & Wasson, J. H. (1996). Estimating treatment benefits for the elderly: The effect of competing risks. Annals of Internal Medicine, 124(6), 577–584.

    PubMed  CAS  Google Scholar 

  18. Mohan, R., Beydoun, H., Barnes-Ely, M. L., Lee, L., Davis, J. W., Lance, R., et al. (2009). Patients’ survival expectations before localized prostate cancer treatment by treatment status. Journal of the American Board of Family Medicine, 22(3), 247–256.

    Article  PubMed  Google Scholar 

  19. NCHS. (2007). In National Vital Statistics Report 54 (14). 28 March 2007.

  20. Fowler, F. J., Jr., McNaughton Collins, M., Albertsen, P. C., Zietman, A., Elliott, D. B., & Barry, M. J. (2000). Comparison of recommendations by urologists and radiation oncologists for treatment of clinically localized prostate cancer. JAMA, 283(24), 3217–3222.

    Article  PubMed  Google Scholar 

  21. Potosky, A. L., Harlan, L. C., Stanford, J. L., Gilliland, F. D., Hamilton, A. S., Albertsen, P. C., et al. (1999). Prostate cancer practice patterns and quality of life: The prostate cancer outcomes study. Journal of the National Cancer Institute, 91(20), 1719–1724.

    Article  PubMed  CAS  Google Scholar 

  22. Chaudhry, S., Jin, L., & Meltzer, D. (2005). Use of a self-report-generated Charlson comorbidity index for predicting mortality. Medical Care, 43(6), 607–615.

    Article  PubMed  Google Scholar 

  23. Hlatky, M. A., Boineau, R. E., Higginbotham, M. B., Lee, K. L., Mark, D. B., Califf, R. M., et al. (1989). A brief self-administered questionnaire to determine functional capacity (The duke activity status index). The American journal of cardiology, 64(10), 651–654.

    Article  PubMed  CAS  Google Scholar 

  24. Hamilton, D. M., & Haennel, R. G. (2000). Validity and reliability of the 6 min walk test in a cardiac rehabilitation population. Journal of Cardiopulmonary Rehabilitation, 20(3), 156–164.

    Article  PubMed  CAS  Google Scholar 

  25. Lee, I. M., Hsieh, C. C., & Paffenbarger, R. S., Jr. (1995). Exercise intensity and longevity in men. The Harvard alumni health study. JAMA, 273(15), 1179–1184.

    Article  PubMed  CAS  Google Scholar 

  26. Zigmond, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67(6), 361–370.

    Article  PubMed  CAS  Google Scholar 

  27. Baigi, A., Hildingh, C., Virdhall, H., & Fridlund, B. (2008). Sense of coherence as well as social support and network as perceived by patients with a suspected or manifest myocardial infarction: A short-term follow-up study. Clinical Rehabilitation, 22(7), 646–652.

    Article  PubMed  Google Scholar 

  28. Zahran, H. S., Kobau, R., Moriarty, D. G., Zack, M. M., Holt, J., & Donehoo, R. (2005). Health-related quality of life surveillance—United States, 1993–2002. MMWR Surveillance Summaries, 54(4), 1–35.

    Google Scholar 

  29. Mossey, J. M., & Shapiro, E. (1982). Self-rated health: a predictor of mortality among the elderly. American Journal of Public Health, 72(8), 800–808.

    Article  PubMed  CAS  Google Scholar 

  30. DeSalvo, K. B., Bloser, N., Reynolds, K., He, J., & Muntner, P. (2006). Mortality prediction with a single general self-rated health question. A meta-analysis. Journal of General Internal Medicine, 21(3), 267–275.

    Article  PubMed  Google Scholar 

  31. Carson, C. (2007). Private practice or academia- making the choice. Urology Times. Feb 2007.

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Acknowledgments

Support for this project was provided in part through grants from the Norfolk Foundation, and the US Health Resources Service Administration Department of Health and Human Services. In addition, the project was supported in part by the intramural research program of the NIH, National Institute on Aging. We would like to thank Mr. Brian Main for his help with the patient database.

Author information

Authors and Affiliations

  1. Department of Family and Community Medicine, Eastern Virginia Medical School, Norfolk, VA, USA

    Ravinder Mohan

  2. Graduate Program in Public Health, Eastern Virginia Medical School, 700 W. Olney Rd, Post Office Box 1980, Norfolk, VA, 23501-1980, USA

    Hind A. Beydoun

  3. National Institute on Aging, Baltimore, MD, USA

    May A. Beydoun

  4. Center for Pediatric Research, Children’s Hospital of King’s Daughters, Norfolk, VA, USA

    Myra Barnes-Eley

  5. Department of Urologic Oncology, M.D. Anderson Cancer Center, Houston, TX, USA

    John Davis

  6. Department of Urology, Eastern Virginia Medical School, Norfolk, VA, USA

    Raymond Lance & Paul Schellhammer

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  1. Ravinder Mohan
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  2. Hind A. Beydoun
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Correspondence to Hind A. Beydoun.

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Mohan, R., Beydoun, H.A., Beydoun, M.A. et al. Self-rated health as a tool for estimating health-adjusted life expectancy among patients newly diagnosed with localized prostate cancer: a preliminary study. Qual Life Res 20, 713–721 (2011). https://doi.org/10.1007/s11136-010-9805-3

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