Comorbidity prevalence among cancer patients: a population-based cohort study of four cancers.
Adolescent
Adult
Aged
Aged, 80 and over
Colonic Neoplasms
/ epidemiology
Comorbidity
England
/ epidemiology
Female
Hodgkin Disease
/ epidemiology
Hospitalization
/ trends
Humans
Logistic Models
Lung Neoplasms
/ epidemiology
Male
Middle Aged
Practice Guidelines as Topic
Prevalence
Rectal Neoplasms
/ epidemiology
Registries
Young Adult
Cancer
Comorbidity
Deprivation
England
Epidemiology
Multimorbidity
Prevalence
Journal
BMC cancer
ISSN: 1471-2407
Titre abrégé: BMC Cancer
Pays: England
ID NLM: 100967800
Informations de publication
Date de publication:
28 Jan 2020
28 Jan 2020
Historique:
received:
08
05
2019
accepted:
17
12
2019
entrez:
29
1
2020
pubmed:
29
1
2020
medline:
29
8
2020
Statut:
epublish
Résumé
The presence of comorbidity affects the care of cancer patients, many of whom are living with multiple comorbidities. The prevalence of cancer comorbidity, beyond summary metrics, is not well known. This study aims to estimate the prevalence of comorbid conditions among cancer patients in England, and describe the association between cancer comorbidity and socio-economic position, using population-based electronic health records. We linked England cancer registry records of patients diagnosed with cancer of the colon, rectum, lung or Hodgkin lymphoma between 2009 and 2013, with hospital admissions records. A comorbidity was any one of fourteen specific conditions, diagnosed during hospital admission up to 6 years prior to cancer diagnosis. We calculated the crude and age-sex adjusted prevalence of each condition, the frequency of multiple comorbidity combinations, and used logistic regression and multinomial logistic regression to estimate the adjusted odds of having each condition and the probability of having each condition as a single or one of multiple comorbidities, respectively, by cancer type. Comorbidity was most prevalent in patients with lung cancer and least prevalent in Hodgkin lymphoma patients. Up to two-thirds of patients within each of the four cancer patient cohorts we studied had at least one comorbidity, and around half of the comorbid patients had multiple comorbidities. Our study highlighted common comorbid conditions among the cancer patient cohorts. In all four cohorts, the odds of having a comorbidity and the probability of multiple comorbidity were consistently highest in the most deprived cancer patients. Cancer healthcare guidelines may need to consider prominent comorbid conditions, particularly to benefit the prognosis of the most deprived patients who carry the greater burden of comorbidity. Insight into patterns of cancer comorbidity may inform further research into the influence of specific comorbidities on socio-economic inequalities in receipt of cancer treatment and in short-term mortality.
Sections du résumé
BACKGROUND
BACKGROUND
The presence of comorbidity affects the care of cancer patients, many of whom are living with multiple comorbidities. The prevalence of cancer comorbidity, beyond summary metrics, is not well known. This study aims to estimate the prevalence of comorbid conditions among cancer patients in England, and describe the association between cancer comorbidity and socio-economic position, using population-based electronic health records.
METHODS
METHODS
We linked England cancer registry records of patients diagnosed with cancer of the colon, rectum, lung or Hodgkin lymphoma between 2009 and 2013, with hospital admissions records. A comorbidity was any one of fourteen specific conditions, diagnosed during hospital admission up to 6 years prior to cancer diagnosis. We calculated the crude and age-sex adjusted prevalence of each condition, the frequency of multiple comorbidity combinations, and used logistic regression and multinomial logistic regression to estimate the adjusted odds of having each condition and the probability of having each condition as a single or one of multiple comorbidities, respectively, by cancer type.
RESULTS
RESULTS
Comorbidity was most prevalent in patients with lung cancer and least prevalent in Hodgkin lymphoma patients. Up to two-thirds of patients within each of the four cancer patient cohorts we studied had at least one comorbidity, and around half of the comorbid patients had multiple comorbidities. Our study highlighted common comorbid conditions among the cancer patient cohorts. In all four cohorts, the odds of having a comorbidity and the probability of multiple comorbidity were consistently highest in the most deprived cancer patients.
CONCLUSIONS
CONCLUSIONS
Cancer healthcare guidelines may need to consider prominent comorbid conditions, particularly to benefit the prognosis of the most deprived patients who carry the greater burden of comorbidity. Insight into patterns of cancer comorbidity may inform further research into the influence of specific comorbidities on socio-economic inequalities in receipt of cancer treatment and in short-term mortality.
Identifiants
pubmed: 31987032
doi: 10.1186/s12885-019-6472-9
pii: 10.1186/s12885-019-6472-9
pmc: PMC6986047
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2Subventions
Organisme : Cancer Research UK
ID : 11700
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/T02481X/1
Pays : United Kingdom
Organisme : Cancer Research UK
ID : C7923/A18525
Pays : United Kingdom
Références
Asia Pac J Clin Oncol. 2016 Mar;12(1):e47-56
pubmed: 24354451
BMJ. 2018 Mar 14;360:k764
pubmed: 29540358
N Engl J Med. 2001 Sep 13;345(11):790-7
pubmed: 11556298
Am J Epidemiol. 2011 Mar 15;173(6):676-82
pubmed: 21330339
BMJ. 2006 May 13;332(7550):1142-4
pubmed: 16690673
Clin Colon Rectal Surg. 2009 Nov;22(4):191-7
pubmed: 21037809
J Public Health (Oxf). 2018 Jun 1;40(2):340-349
pubmed: 28655212
J Clin Epidemiol. 1996 Dec;49(12):1373-9
pubmed: 8970487
World Health Stat Q. 1988;41(1):32-6
pubmed: 3376487
Lancet. 2012 Jul 7;380(9836):37-43
pubmed: 22579043
Lancet. 2007 Sep 1;370(9589):741-50
pubmed: 17765523
BMC Cancer. 2009 Apr 20;9:116
pubmed: 19379520
JAMA. 2012 Jun 20;307(23):2493-4
pubmed: 22797447
Br J Gen Pract. 2011 Jan;61(582):e12-21
pubmed: 21401985
Diabetes Care. 2001 Sep;24(9):1590-5
pubmed: 11522704
J Epidemiol Community Health. 2004 Jan;58(1):71-7
pubmed: 14684730
PLoS One. 2017 Mar 6;12(3):e0172814
pubmed: 28263996
Oncologist. 2005 Mar;10(3):198-204
pubmed: 15793223
Clin Epidemiol. 2020 Jan 14;12:31-40
pubmed: 32021469
Age Ageing. 2013 Jan;42(1):62-9
pubmed: 22910303
Med Care. 2014 Jun;52(6):482-9
pubmed: 24824535
Eur J Public Health. 2013 Dec;23(6):991-7
pubmed: 23243133
Fam Pract. 2011 Oct;28(5):516-23
pubmed: 21436204
Lancet. 2005 Nov 19;366(9499):1784-93
pubmed: 16298215
BMC Health Serv Res. 2015 Jan 22;15:23
pubmed: 25609174
CA Cancer J Clin. 2016 Jul;66(4):337-50
pubmed: 26891458
Thorax. 2019 Jan;74(1):51-59
pubmed: 30100577
J Chronic Dis. 1987;40(5):373-83
pubmed: 3558716
Eur J Gen Pract. 2004 Mar;10(1):24-6
pubmed: 15060478
J Clin Oncol. 2004 Aug 1;22(15):3099-103
pubmed: 15284260
J Public Health (Oxf). 2012 Aug;34(3):390-6
pubmed: 22375070
Thorax. 2017 May;72(5):430-436
pubmed: 27682330
J Natl Cancer Inst. 2018 Nov 1;110(11):1201-1207
pubmed: 29788259
Int J Environ Res Public Health. 2009 Jan;6(1):209-24
pubmed: 19440278
Cancer. 2007 Jun 15;109(12):2410-9
pubmed: 17510973
QJM. 2012 Feb;105(2):167-75
pubmed: 21964722
Ann Fam Med. 2005 May-Jun;3(3):223-8
pubmed: 15928225
BMC Cancer. 2016 Sep 05;16:715
pubmed: 27595733
Br J Gen Pract. 2008 Feb;58(547):128-30; discussion 130
pubmed: 18307864
Br J Cancer. 2015 Nov 3;113(9):1375-80
pubmed: 26461060
J Epidemiol Community Health. 2000 Mar;54(3):173-7
pubmed: 10746110
J Clin Epidemiol. 2012 Sep;65(9):924-33
pubmed: 22739245
BMC Health Serv Res. 2012 Apr 03;12:89
pubmed: 22471952
J R Soc Med. 2006 Feb;99(2):81-9
pubmed: 16449782
BMC Med. 2017 Dec 08;15(1):216
pubmed: 29221453
Br J Gen Pract. 2014 Jul;64(624):e440-7
pubmed: 24982497
BMC Fam Pract. 2015 Oct 14;16:129
pubmed: 26462820