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Deprivation, comorbidity and survival in a cohort of patients with colorectal cancer
Author(s) -
MUNRO A.J.,
BENTLEY A.H.M.
Publication year - 2004
Publication title -
european journal of cancer care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.849
H-Index - 67
eISSN - 1365-2354
pISSN - 0961-5423
DOI - 10.1111/j.1365-2354.2004.00480.x
Subject(s) - comorbidity , medicine , proportional hazards model , hazard ratio , survival analysis , univariate analysis , cohort , log rank test , cancer survival , confidence interval , oncology , cancer , multivariate analysis
We studied a regionally based cohort of 483 consecutive patients with colorectal cancer referred for chemotherapy and/or radiotherapy. These patients were assessed and managed according to consistent policies. We investigated the effects of socio‐economic deprivation and comorbidity upon survival. Significant comorbidity was present in 48% of the patients. Overall survival and cause‐specific survival were summarized using Kaplan‐Meier curves. Equality of survivor functions was assessed using the logrank procedure and Cox's proportional hazards analysis. In univariate analysis, the following variables significantly affected survival: comorbidity, performance status, age and clinical stage. We could find no correlation between deprivation and comorbidity. The presence of comorbidity significantly affected cause‐specific survival (3‐year cause‐specific survival without comorbidity 54.2%; with comorbidity 44.6%). In adjusted analysis, deprivation had an independently adverse effect on overall survival, hazard ratio 1.04 (95% confidence interval 1.00–1.08), but this was only of borderline statistical significance, P = 0.049. This study demonstrates that the interrelationships between comorbidity, deprivation and outcome in this group of patients are complex: even when care is readily available, patient assessments are uniform, and clinical decision making is consistent.