# Personalized Life Expectancy to Encourage High Value Prostate Cancer Care

> **NIH VA I01** · VETERANS ADMIN PALO ALTO HEALTH CARE SYS · 2020 · —

## Abstract

As an integrated system with access to granular and longitudinal data, the Veterans Health administration
(VHA) is ideally positioned to advance the understanding of the life expectancy, to improve prostate cancer
screening strategies, and to generate models of personalized risk-adjusted life expectancy estimates to
provide critical information to inform prostate cancer treatment decisions.
Veterans receiving care in the Veterans Health Administration may have higher prostate cancer risk due to a
family history, race, or exposure to toxins such as Agent Orange and burn pits. Prostate cancer presents a
clinical, health policy, and population health challenge. Prostate cancer is the most common male cancer,
presents in older men that may have additional medical conditions, and often follows an indolent course. It
is estimated that 60% of all prostate cancer cases represent an “overdiagnosis” of clinically insignificant
tumors. For prostate cancer patients, “overdiagnosis” refers to the diagnosis of a disease process that would
otherwise not go on to cause symptoms or death. Similarly, “overtreatment” refers to the treatment of
prostate cancers that would not otherwise go on to cause symptoms or death.
Our objective is to leverage the power of the standardized electronic health record in the VHA to generate
personalized risk-adjusted life expectancy estimates. We will use these estimates to provide critical
information to inform prostate cancer screening and treatment medical decision-making. These efforts have
the potential to deliver higher quality prostate cancer care, by treating patients most likely to benefit, and
while avoiding futile treatment and minimizing treatment-related side effects.
We will work to develop life expectancy estimates for all male veterans receiving care in the VHA and
evaluate how a diagnosis of prostate cancer may modify these estimates. (Aim 1) Next, we use several
approaches to generate personalized life expectancy estimates for patients with a diagnosis of prostate
cancer. These estimates will use data from the electronic health record including age, race/ethnicity, prior
medical claims, disease severity, exposure, health habits, pharmacy, and laboratory data for military
beneficiaries receiving care in the VHA. (Aim 2) These estimates will include efforts to use machine learning
approaches to generate the best-fitting model of overall survival. Finally, we will estimate the overdiagnosis
and overtreatment of prostate cancer in the VHA using the general and personalized life expectancy
estimates. (Aim 3)

## Key facts

- **NIH application ID:** 9768237
- **Project number:** 5I01HX002126-03
- **Recipient organization:** VETERANS ADMIN PALO ALTO HEALTH CARE SYS
- **Principal Investigator:** John Thomas Leppert
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2020
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2017-03-01 → 2021-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9768237

## Citation

> US National Institutes of Health, RePORTER application 9768237, Personalized Life Expectancy to Encourage High Value Prostate Cancer Care (5I01HX002126-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9768237. Licensed CC0.

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