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A study is undertaken of African American and white breast cancer patients to examine the contribution of comorbidity to the survival discrepancies among black and white patients. Observations reveal that the death of more African American breast cancer patients is attributable to competing or non-breast cancer reasons, and an effective control of comorbidity in these patients should promote life expectancy and reduce survival discrepancies.

Objective: This study evaluates the relationship between sociodemographic/exposure factors and comorbidity, and their impact on lung cancer treatment and survival.Study and design setting: Data for 1,155 patients were abstracted from the Josephine Ford Cancer Center Tumor Registry and medical records. Associations were analyzed by linear, logistic, and Cox regression.Results: Approximately 88% of patients had ⩾1 of 56 comorbidities assessed. In multivariate analysis, comorbidity count was associated with older age, pack-years smoked, heavy alcohol use, lower socioeconomic status (SES), and female gender. Approximately 63% of patients had ⩾1 of 18 adverse prognostic comorbidities (AC), and significant independent predictors of AC were age, pack-years, African–American race/ethnicity, and gender. In multivariate analysis, comorbidity count and AC predicted nonreceipt of surgery in localized disease (OR⩾1 vs. 0 AC = 0.38, 95% 0.18, 0.81) and chemotherapy in advanced disease (OR⩾1 vs. 0 AC = 0.72, 95% 0.51, 1.00). In adjusted analysis, comorbidity predicted survival in localized (hazard ratio (HR)⩾2 vs. 0 AC = 2.99, 95% CI 1.75, 5.10) and advanced lung cancer (HR⩾2 vs. 0 AC = 1.56, 95% CI 1.25, 1.94).Conclusion: Comorbidity has important deleterious effects on lung cancer outcomes and significant predictors of comorbidity included age, smoking, race/ethnicity, SES, alcohol, and gender. [Copyright &y& Elsevier]

Objective: To assess the role of secondhand smoke (SHS) in the etiology of chronic rhinosinusitis (CRS)., Design: Matched case-control study. Associations between SHS and CRS were evaluated by conditional logistic regression odds ratios., Setting: Henry Ford Health System, Detroit, Michigan., Participants: A total of 306 nonsmoking patients diagnosed as having an incident case of CRS and 306 age-matched, sex-matched, and race/ethnicity-matched nonsmoking control patients., Main Outcome Measures: Exposure to SHS for the 5 years before diagnosis of CRS (case patients) and before study entry (controls) for 4 primary sources: home, work, public places, and private social functions outside the home, such as parties, dinners, and weddings., Results: Of controls and case patients, respectively, 28 (9.1%) and 41 (13.4%) had SHS exposure at home, 21 (6.9%) and 57 (18.6%) at work, 258 (84.3%) and 276 (90.2%) in public places, and 85 (27.8%) and 157 (51.3%) at private social functions. Adjusted for potential confounders (socioeconomic status and exposures to air pollution and chemicals or respiratory irritants from hobbies, work, or elsewhere), the odds ratios for CRS were 1.69 (95% confidence interval, 0.92-3.10) for SHS exposure at home, 2.81 (1.42-5.57) for exposure at work, 1.48 (0.88-2.49) for exposure in public places, and 2.60 (1.74-3.89) for exposure at private functions. A strong, independent dose-response relationship existed between CRS and the number of venues where SHS exposure occurred (odds ratio per 1 of 4 levels, 2.03; 95% confidence interval, 1.55-2.66). Approximately 40.0% of CRS appeared to be attributable to SHS., Conclusions: Exposure to SHS is common and significantly independently associated with CRS. These findings have important clinical and public health implications.