Significant Increased Risk of Noncancer Hospitalization Following Diagnosis of Prostate Cancer in the Elderly

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Elderly men had a significant increase in the risk of noncancer hospitalizations following the diagnosis of prostate cancer, according to a population-based retrospective cohort study conducted by Amit D. Raval, PhD, and colleagues at West Virginia University, Morgantown. Results were published in the Journal of the National Comprehensive Cancer Network.

The study cohort consisted of 57,489 men with incident prostate cancer identified through the SEER-Medicare linked database for 2000 through 2010. The cohort was restricted to those who had continuous fee-for-service Medicare Part A and B enrollment during the entire study period and were aged ≥ 67 years, so health-care utilization data would be available for at least 2 years before the diagnosis of prostate cancer. Most were white (82.4%) and married (68.5%), with a mean age of 74.6 years.

Noncancer hospitalizations were grouped into six time periods of 120 days each: three periods accounting for the 12 months before the diagnosis of cancer and three for the 12 months afterward. Within each period, noncancer hospitalizations were defined as inpatient admissions with primary diagnosis codes not related to prostate cancer; prostate cancer–related procedures; or bowel, sexual, and urinary dysfunction.

The rates of noncancer hospitalizations were highest (5.1%) during the 120 days immediately following the prostate cancer diagnosis and lowest (3.2%) during the precancer period. “In both unadjusted and adjusted models, elderly men were 37% (odds ratio, 1.37; 95% confidence interval [CI] = 1.32–1.41) and 38% (adjusted odds ratio, 1.38; 95% CI = 1.33–1.46) more likely to have any noncancer hospitalization during the postcancer period compared with the precancer period,” the investigators found.

“Elderly men with cardiometabolic conditions alone and those with a combination of cardiometabolic and respiratory or mental health conditions were most vulnerable to an increased risk of noncancer hospitalization,” the researchers reported. “In this regard, optimizing care in the clinical settings by focusing on the ‘ABCS’ (aspirin when appropriate, blood pressure control, cholesterol management, and smoking cessation) can help reduce the risk of noncancer hospitalization.” ■

Raval AD, et al: J Natl Compr Canc Netw 14:186-194, 2016.

In the Literature is compiled and written for The ASCO Post by Charlotte Bath.




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