St. Louis, November 2, 1999 -- Jay F. Piccirillo, M.D., associate professor of otolaryngology and head and neck surgery at Washington University School of Medicine in St. Louis, has received a one-year $98,000 grant from the Longer Life Foundation. The grant will allow Piccirillo to create an interactive, computer program for physicians and their adult patients recently diagnosed with cancers to estimate their life expectancy when other medical conditions and other factors are considered.

Hospitals maintain computer databases providing information on patients' age, gender, race, and the type and severity of their cancer. For privacy reasons, each patient is assigned a confidential number in the database. This information is sent to state databases, ultimately contributing to national cancer statistics. Analyzing the information helps medical personnel improve patient care.

Since 1994, the cancer database, or registry, at Barnes-Jewish Hospital in St. Louis also has included information on comorbidity — a patient's additional medical conditions. The grant from the Longer Life Foundation will allow Piccirillo to combine data from the hospital's registry and the Surveillance Epidemiology and End Results (SEER) program of the National Cancer Institute. This will enable him to create a unique computer program for calculating the survival times of patients with common cancers and specific comorbid conditions.

"How sick a patient is from other medical conditions will impact survival — sometimes more so than the impact of the tumor," says Piccirillo. He previously created a similar interactive, computer program for head and neck cancer patients that he uses in discussions with patients as an attending physician at Barnes-Jewish Hospital. He also directs the Department of Otolarygnology's Clinical Outcomes Research Office.

To generate unique survival curves, Piccirillo will analyze data from the more than 10,000 new cancer patients who received care at Barnes-Jewish Hospital between 1995 and 1997. To obtain similar survival curves from a national sample, Piccirillo will use data from the SEER database. However, since the SEER database does not currently collect comorbidity information, Piccirillo will adjust the SEER survival curves using comorbidity information from the Barnes-Jewish registry.

The data processing work will be completed in 2000. Piccirillo and his colleagues will then study the impact of this life expectancy and prognostic information on patient care. They also will address the usefulness of providing this information in an "open environment," such as the World Wide Web.

The Longer Life Foundation funds efforts to increase the understanding of factors that influence longevity and wellness. It was established by Reinsurance Group of America Inc.(RGA) and the School of Medicine in May 1998. RGA is a leading life reinsurance company in North America, and operates internationally.

Note: The SEER program is available on the SEER*Stat 1973-1996 Public-Use CD-ROM.

The full-time and volunteer faculty of Washington University School of Medicine are the physicians and surgeons of Barnes-Jewish and St. Louis Children's hospitals. The School of Medicine is one of the leading medical research, teaching and patient care institutions in the nation. Through its affiliations with Barnes-Jewish and St. Louis Children's hospitals, the School of Medicine is linked to BJC Health System.