Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD 20892, USA.
J Clin Epidemiol. 2013 Dec;66(12):1376-85. doi: 10.1016/j.jclinepi.2013.07.002. Epub 2013 Sep 10.
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.
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.
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.
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.
为了更准确地估计癌症患者的非癌症死亡率相关预期寿命，我们估算了调整合并症后的生命表和健康调整年龄。
利用监测、流行病学和最终结果-医疗保险数据库的数据，我们估算了反映癌症诊断前一年 66 岁及以上人群健康状况的合并症评分。根据合并症评分，估算了每个年龄、种族和性别的非癌症生存率。通过系统比较非癌症生存模型与美国生命表来估算健康调整年龄。
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，它们对非癌症生存的相对影响随着年龄的增长而降低。基于合并症的生存模型比美国生命表更好地预测了非癌症生存。健康调整年龄和国家生命表可以用来提供一个人预期寿命的近似估计，例如，无合并症的 75 岁黑人男性的健康调整年龄为 67 岁，预期寿命为 13 年。
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提供重要信息，有助于决策癌症和其他疾病的治疗。
