The impact of comorbidity on cancer survival: a review
Mette Søgaard,Reimar W. Thomsen,Kristine Skovgaard Bossen,Henrik Toft Sørensen,Mette Nørgaard +4 more
Reads0
Chats0
TLDR
In general, comorbidity does not appear to be associated with more aggressive types of cancer or other differences in tumor biology, and it is unclear from the literature whether the apparent undertreatment reflects appropriate consideration of greater toxicity risk, poorer clinical quality, patient preferences, or poor adherence among patients with comor bidity.Abstract:
Background A number of studies have shown poorer survival among cancer patients with comorbidity. Several mechanisms may underlie this finding. In this review we summarize the current literature on the association between patient comorbidity and cancer prognosis. Prognostic factors examined include tumor biology, diagnosis, treatment, clinical quality, and adherence. Methods All English-language articles published during 2002-2012 on the association between comorbidity and survival among patients with colon cancer, breast cancer, and lung cancer were identified from PubMed, MEDLINE and Embase. Titles and abstracts were reviewed to identify eligible studies and their main results were then extracted. Results Our search yielded more than 2,500 articles related to comorbidity and cancer, but few investigated the prognostic impact of comorbidity as a primary aim. Most studies found that cancer patients with comorbidity had poorer survival than those without comorbidity, with 5-year mortality hazard ratios ranging from 1.1 to 5.8. Few studies examined the influence of specific chronic conditions. In general, comorbidity does not appear to be associated with more aggressive types of cancer or other differences in tumor biology. Presence of specific severe comorbidities or psychiatric disorders were found to be associated with delayed cancer diagnosis in some studies, while chronic diseases requiring regular medical visits were associated with earlier cancer detection in others. Another finding was that patients with comorbidity do not receive standard cancer treatments such as surgery, chemotherapy, and radiation therapy as often as patients without comorbidity, and their chance of completing a course of cancer treatment is lower. Postoperative complications and mortality are higher in patients with comorbidity. It is unclear from the literature whether the apparent undertreatment reflects appropriate consideration of greater toxicity risk, poorer clinical quality, patient preferences, or poor adherence among patients with comorbidity. Conclusion Despite increasing recognition of the importance of comorbid illnesses among cancer patients, major challenges remain. Both treatment effectiveness and compliance appear compromised among cancer patients with comorbidity. Data on clinical quality is limited.read more
Citations
More filters
Journal ArticleDOI
Microvascular reconstruction for head and neck cancers in high risk population: clinical outcomes and complications.
Rakesh Katna,Rakesh Katna,Shambhavi Singh,Bharat Bhosale,Bharat Bhosale,A Deshpande,A Deshpande,Nikhil Kalyani,Neck +8 more
TL;DR: In this paper, the impact of age and comorbidities on the type of microvascular reconstruction in oral cavity cancer was analyzed and compared with other types of reconstructions.
Journal ArticleDOI
Patient-Reported Symptom Burden and Supportive Care Needs of Patients With Stage II-III Colorectal Cancer During and After Adjuvant Systemic Treatment: A Real-World Evidence Study
TL;DR: In this paper , the authors used patient-reported outcomes and administrative health data to describe symptom burden and supportive care needs during and after adjuvant treatment and determine factors associated with changes to symptom burden.
Journal ArticleDOI
Adjusting for comorbidity in observational cancer studies: A systematic review to assess alignment between index and study.
TL;DR: The authors in this paper provided a contemporaneous snapshot of comorbidity indices used in retrospective observational cancer studies and the extent to which cancer type, data source, and outcome matched the studies in which the indices were developed.
Journal ArticleDOI
Clinical benefit of pembrolizumab in treatment of first line non-small cell lung cancer: a systematic review and meta-analysis of clinical characteristics
TL;DR: In this paper , the authors performed a systematic review and meta-analysis to evaluate the clinical benefit of pembrolizumab in treatment of first-line non-small cell lung cancer (NSCLC).
Journal Article
Leveraging Social Determinants of Health to Reduce Hospital Length of Stay: A Pilot QI Project for Solid Tumor Oncology Patients During the COVID-19 Pandemic.
Tess Kamaraju,Dave Atkinson,Tamiah Wright,John Charlosn,Thomas A. Wetzel,Grace Campbell,Jennifer Cadman,John Williams,Leonard E. Egede,Janet Retseck,Anjishnu Banerjee,Valarie Ehrlich,Melinda R. Stolley,Steve Power +13 more
TL;DR: The SDOH survey tool assisted in a timely examination of patient-specific barriers to discharge, leveraged care coordination, and facilitated a safe hospital discharge, and increase the efficiency of health care service delivery in response to public health threats, such as the COVID-19 pandemic.
References
More filters
Journal ArticleDOI
A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation☆
TL;DR: The method of classifying comorbidity provides a simple, readily applicable and valid method of estimating risk of death fromComorbid disease for use in longitudinal studies and further work in larger populations is still required to refine the approach.
Journal ArticleDOI
Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study
TL;DR: The findings challenge the single-disease framework by which most health care, medical research, and medical education is configured, and a complementary strategy is needed, supporting generalist clinicians to provide personalised, comprehensive continuity of care, especially in socioeconomically deprived areas.
Journal ArticleDOI
A dictionary of epidemiology
TL;DR: The new edition of this classic text remains the definitive dictionary in epidemiology, and the dictionary goes beyond simple definitions, as it place each term firmly and clearly in its fuller epidemiologic context.
Journal ArticleDOI
Underrepresentation of patients 65 years of age or older in cancer-treatment trials.
TL;DR: There is substantial under representation of patients 65 years of age or older in studies of treatment for cancer, and the reasons should be clarified, and policies adopted to correct this underrepresentation.
Journal ArticleDOI
Cumulative illness rating scale.
TL;DR: A Cumulative Illness Rating Scale, designed to meet the need for a brief, comprehensive and reliable instrument for assessing physical impairment, has been developed and tested and is well suited to a variety of research uses.