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Background:   The presence of comorbidities may play an important role in the way treatment plans are developed for management of cancer. The aim of this study was to investigate the prevalence and impact of comorbidities in a retrospective nationwide population-based study of patients with oral cavity cancers.Material and methods:   A total of 16,676 oral cavity cancer patients diagnosed in the period 2007–2010 were identified through the Taiwan Cancer Registry database. By linking this data set to the National Health Insurance Research Database and the death registry, information on comorbidity and cause of death was obtained and adapted to the Charlson’s comorbidity index. The influence of comorbidity on overall survival and cancer-related death was evaluated by Kaplan–Meier estimates and Cox regressions.Results:   In total, 21.3% of patients had some comorbidity during the year before cancer diagnosis. Diabetes mellitus was found to be the most common comorbidity (10%). Methods of management were significantly different in patients with stages 2, 3 and 4 of the disease. Those with severe comorbidity conditions received less surgical interventions (5–13%) compared with the patients without any comorbidity. Differences in the survival rates were only significant in all-cause death, but not in cancer-related death in the early stages (stages 1 and 2). Two-year survival rates for patients with severe comorbidity conditions were lower by 10–22% given the same stage of disease and treatment modality.Conclusion:   The survival rates of oral cancer patients in early stages are lower in patients with comorbidity conditions and this may be due to the less aggressive cancer treatment offered to this group of patients. Comorbidities affect the decision on cancer treatment modality and thereby outcomes.

Effect of comorbidities on the management and prognosis in patients with oral cancer