A Comparison of Cause of Death Determination in Men Previously Diagnosed With Prostate Cancer Who Died in 1985 or 1995

Albertsen, Peter C.; Walters, Sue; Hanley, James A.

doi:10.1016/s0022-5347(05)67915-3

Cited by 97 publications

(39 citation statements)

References 9 publications

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“…Given the high accuracy of Swedish death certificates – 96% agreement with the cause of death committee in the Göteborg trial – as well as no support of any change in cause of death determination in a study of men dying from prostate cancer before versus after the introduction of PSA, we find cause of death misattribution unlikely. [25, 26]…”

Section: Discussionmentioning

confidence: 99%

Screening for Prostate Cancer Starting at Age 50–54 Years. A Population-based Cohort Study

et al. 2017

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Background Current prostate cancer screening guidelines conflict with respect to the age at which to initiate screening. Objective To evaluate the effect of prostate-specific antigen (PSA) screening, versus zero screening, starting at age 50-54, on prostate cancer mortality. Design, Setting, and Participants This is a population-based cohort study comparing 3,479 men aged 50 through 54 randomized to PSA-screening in the Göteborg population-based prostate cancer screening trial, initiated in 1995, versus 4,060 unscreened men aged 51 to 55 providing cryopreserved blood in the population-based Malmö Preventive Project in the pre-PSA era, during 1982-1985. Outcome measures and Statistical Analysis Cumulative incidence and incidence rate ratios of prostate cancer diagnosis, metastasis, and prostate cancer death. Results and Limitation At 17 years, regular PSA-screening in Göteborg of men in their early 50s carried a more than 2-fold higher risk of prostate cancer diagnosis compared to the unscreened men in Malmö (IRR 2.56, 95% CI 2.18, 3.02), but resulted in a substantial decrease in risk of metastases (IRR 0.43, 95% CI 0.22, 0.79) and prostate cancer death (IRR 0.29, 95% CI 0.11, 0.67). There were 57 fewer prostate cancer deaths per 10,000 men (95% CI 22, 92) in the screened group. At 17 years, the number needed to invite to PSA-screening and the number needed to diagnose to prevent one prostate cancer death was 176 and 16, respectively. The study is limited by lack of treatment information and the comparison of two different birth cohorts. Conclusions PSA screening for prostate cancer can decrease prostate cancer mortality among men aged 50–54, with NNI and NND comparable to those previously reported from the European Randomized Study of Screening for Prostate Cancer for men aged 55-69 years, at similar follow-up. Guideline groups could consider whether guidelines for PSA screening should recommend starting no later than at ages 50-54. Trial registration The Göteborg randomized population-based prostate cancer screening trial is registered with the ISRCTN registry (isrctn.com). Identifier: ISRCTN54449243.

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Section: Discussionmentioning

confidence: 99%

Screening for Prostate Cancer Starting at Age 50–54 Years. A Population-based Cohort Study

et al. 2017

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“…These inaccuracies may be due to insufficient knowledge of the decedent's medical history by the certifier [42]. Others, however, have reported high-level agreement between the underlying cause of death and medical records, as was the case in studies in prostate patients with cancer [43,44]. Also, in contrast to our use of the underlying cause of death to identify patients dying from cancer, future studies should explore the utility of using multiple causes of death, as documented in a study on deaths from myelodysplastic syndromes [45].…”

Section: Discussionmentioning

confidence: 99%

Social determinants, multimorbidity, and patterns of end-of-life care in older adults dying from cancer

Koroukian

Schiltz

Warner

et al. 2017

Journal of Geriatric Oncology

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Objective Most prior studies on aggressive end-of-life care in older patients with cancer have accounted for social determinants of health (e.g., race, income, and education), but rarely for multimoribidity (MM). In this study, we examine the association between end-of-life care and each of the social determinants of health and MM, hypothesizing that higher MM is associated with less aggressive care. Methods From the linked 1991–2008 Health and Retirement Study, Medicare data, and the National Death Index, we identified fee-for-service patients age ≥66 years who died from cancer (n = 835). MM was defined as the occurrence or co-occurrence of chronic conditions, functional limitations, and/or geriatric syndromes. Aggressive care was based on claims-derived measures of receipt of cancer-directed treatment in the last two weeks of life; admission to the hospital and/or emergency department (ED) within the last month; and in-hospital death. We also identified patients enrolled in hospice. In multivariable logistic regression models, we analyzed the associations of interest, adjusting for potential confounders. Results While 61.2% of the patients enrolled in hospice, 24.6% underwent cancer-directed treatment; 55.1% were admitted to the hospital and/or ED; and 21.7% died in the hospital. We observed a U-shaped distribution between income and in-hospital death. Chronic conditions and geriatric syndromes were associated with some outcomes, but not with others. Conclusions To improve quality end-of-life care and curtail costs incurred by dying patients, relevant interventions need to account for social determinants of health and MM in a nuanced fashion.

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“…Misattribution of cause of death (Albertsen et al , 2000; Black et al , 2002) is an important potential source of bias in trials with cancer-specific mortality as the primary end point. Small inaccuracies in attributing cause of death can have the potential to alter the results if misclassification is differential between study arms.…”

Section: Discussionmentioning

confidence: 99%

“…To minimise potential attribution bias (Albertsen et al , 2000; Black et al , 2002), an international Cause of Death Evaluation (CODE) Committee reviews clinical information abstracted from medical records (vignettes) on all possible prostate cancer deaths in both arms of the trial (independent chair: professor Peter Albertsen, Connecticut, USA). A list of specific ICD9 and ICD10 codes, adapted from those used by the PLCO Screening Trial (Miller et al , 2000), is used to identify a possible prostate cancer event from the ICD codes listed in parts I and II of each man's death certificate.…”

Section: Methodsmentioning

confidence: 99%

Design and preliminary recruitment results of the Cluster randomised triAl of PSA testing for Prostate cancer (CAP)

Turner¹,

Metcalfe²,

Donovan³

et al. 2014

Br J Cancer

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Background:Screening for prostate cancer continues to generate controversy because of concerns about over-diagnosis and unnecessary treatment. We describe the rationale, design and recruitment of the Cluster randomised triAl of PSA testing for Prostate cancer (CAP) trial, a UK-wide cluster randomised controlled trial investigating the effectiveness and cost-effectiveness of prostate-specific antigen (PSA) testing.Methods:Seven hundred and eighty-five general practitioner (GP) practices in England and Wales were randomised to a population-based PSA testing or standard care and then approached for consent to participate. In the intervention arm, men aged 50–69 years were invited to undergo PSA testing, and those diagnosed with localised prostate cancer were invited into a treatment trial. Control arm practices undertook standard UK management. All men were flagged with the Health and Social Care Information Centre for deaths and cancer registrations. The primary outcome is prostate cancer mortality at a median 10-year-follow-up.Results:Among randomised practices, 271 (68%) in the intervention arm (198 114 men) and 302 (78%) in the control arm (221 929 men) consented to participate, meeting pre-specified power requirements. There was little evidence of differences between trial arms in measured baseline characteristics of the consenting GP practices (or men within those practices).Conclusions:The CAP trial successfully met its recruitment targets and will make an important contribution to international understanding of PSA-based prostate cancer screening.

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A Comparison of Cause of Death Determination in Men Previously Diagnosed With Prostate Cancer Who Died in 1985 or 1995

Cited by 97 publications

References 9 publications

Screening for Prostate Cancer Starting at Age 50–54 Years. A Population-based Cohort Study

Screening for Prostate Cancer Starting at Age 50–54 Years. A Population-based Cohort Study

Social determinants, multimorbidity, and patterns of end-of-life care in older adults dying from cancer

Design and preliminary recruitment results of the Cluster randomised triAl of PSA testing for Prostate cancer (CAP)

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