Impact of comorbidity on survival by tumour location: Breast, colorectal and lung cancer (2000–2014). (August 2017)

• Record Type: Journal Article
• Authors: Parés-Badell, Oleguer; Banqué, Marta; Macià, Francesc; Castells, Xavier; Sala, Maria
• Is Part Of: Cancer epidemiology. Volume 49(2017:Aug.)
• Page Start: 66
• Page End: 74
• Publication Date: 2017-08
• Subjects: Breast cancer -- Colorectal cancer -- Lung cancer -- Comorbidity -- Survival; Cancer -- Epidemiology -- Periodicals; Cancer -- Prevention -- Periodicals; Cancer -- Diagnosis -- Periodicals; Carcinogenesis -- Periodicals; 616.994005
• DOI: 10.1016/j.canep.2017.05.010
• Languages: English
• ISSNs: 1877-7821

Abstract

Highlights: Comorbidity is a significant predictor of overall survival in cancer patients. The impact of comorbidity on cancer survival varies depending on cancer location. In breast cancer, having a higher CCI is strongly associated to lower survival. In lung cancer, an association between CCI and survival could not be found. Abstract: Background: To assess the impact of comorbidity, measured by the Charlson Comorbidity Index (CCI), on survival in breast, colorectal and lung cancer. Methods: We identified 3455 breast cancer, 3336 colorectal cancer and 2654 lung cancer patients through the Hospital del Mar cancer registry. The prevalence of comorbidities according to the CCI was calculated. Kaplan-Meier curves and the log-rank test were used to compare survival curves for each cancer location. Cox regression was used to calculate survival hazard ratios and 1-, 3- and 5-year mortality rate ratios adjusted by age, sex, CCI, place of first consultation, stage, treatment and period of diagnosis. Results: The overall unadjusted 5-year follow-up survival proportion was 82.6% for breast cancer, 55.7% for colorectal cancer, and 16.3% for lung cancer. Overall survival was associated with CCI ≥ 3 in breast cancer (HR: 2.33 95%CI: 1.76–3.08), colorectal cancer (HR: 1.39; 95%CI: 1.13–1.70) and lung cancer (HR: 1.22; 95%CI: 1.06–1.40). In breast cancer, the higher the CCI, the higher the adjusted mortality rate ratio and differences were greater in 5-year than in 1-year follow-up survival. Conclusions: Comorbidity is a significant predictor of overall survival in cancer patients; however, it has a stronger impact on survival in breast cancer than in colorectal and lung cancer.