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Comorbidity and age as predictors of risk for early mortality of male and female colon carcinoma patients
Author(s) -
Yancik Rosemary,
Wesley Margaret N.,
Ries Lynn A. G.,
Havlik Richard J.,
Long Sherrill,
Edwards Brenda K.,
Yates Jerome W.
Publication year - 1998
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/(sici)1097-0142(19980601)82:11<2123::aid-cncr6>3.0.co;2-w
Subject(s) - medicine , comorbidity , epidemiology , disease , concomitant , medical record
BACKGROUND Colon carcinoma primarily affects older‐aged persons 65 years and older. Seventy‐five percent of the incident tumors affect persons in this age group. Because of their advanced age, older patients already may be coping with other concomitant major physical illnesses. This article documents preexisting diseases in older colon carcinoma patients at diagnosis and evaluates the effects of their comorbidity burden on early mortality. METHODS Prevalence of comorbid conditions was assessed by a retrospective medical records review of an age‐stratified random sample of male and female patients aged 55‐64 years, 65‐74 years, and 75+ years (males, n = 799; females, n = 811). Data were collected on comorbidity by the National Institute on Aging (NIA) and National Cancer Institute (NCI) and merged with NCI Surveillance, Epidemiology, and End Results (SEER) tumor registry data. RESULTS Hypertension, high impact heart conditions, gastrointestinal problems, arthritis, and chronic obstructive pulmonary disease emerged as the most prominent comorbid conditions in the NIA/NCI SEER study sample. The prevalence of comorbidity in the number and type of conditions similar for both men and women (e.g., 40% of each gender had ≥ 5 comorbidities). Within 2 years of diagnosis, 28% (n = 454) of the patients had died. The number of comorbid conditions was significant in predicting early mortality in a model including age, gender, and disease stage ( P = 0.0007). Certain comorbidities, classified as "current problem," added significantly to a basic model (e.g., heart problems, alcohol abuse, liver disease, and deep vein thrombosis). CONCLUSIONS Although disease stage at time of diagnosis of colon carcinoma is a crucial determinant of patient outcome, comorbidity increases the complexity of cancer management and affects survival duration. Cancer control and treatment research questions should address comorbidity issues pertinent to the age group primarily afflicted with colon carcinoma (i.e., the elderly). Cancer 1998;82:2123‐2134. © 1998 American Cancer Society.