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Cancer Epidemiol. 2017 Aug;49:66-74. doi: 10.1016/j.canep.2017.05.010. Epub 2017 Jun 3.

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

Author information

1
Department of Epidemiology and Evaluation, IMIM (Hospital del Mar Medical Research Institute), Barcelona 08003, Spain; Public Health Agency of Barcelona, 1 Pl. de Lesseps, Barcelona, 08023, Spain.
2
Department of Epidemiology and Evaluation, IMIM (Hospital del Mar Medical Research Institute), Barcelona 08003, Spain; European Higher Education Area (EHEA) Degree Programme in Preventive Medicine and Public Health, Fundació Universitària del Bages (FUB), Manresa 08243, Barcelona, Spain; Research network on health services in chronic diseases (REDISSEC), Madrid 28029, Spain. Electronic address: mbanque@hospitaldelmar.cat.
3
Department of Epidemiology and Evaluation, IMIM (Hospital del Mar Medical Research Institute), Barcelona 08003, Spain; Research network on health services in chronic diseases (REDISSEC), Madrid 28029, Spain.
4
Department of Epidemiology and Evaluation, IMIM (Hospital del Mar Medical Research Institute), Barcelona 08003, Spain; Research network on health services in chronic diseases (REDISSEC), Madrid 28029, Spain; European Higher Education Area (EHEA) Doctoral Programme in Public Health in Department of Paediatrics, Obstetrics and Gynaecology, Preventive Medicine and Public Health, Universitat Autònoma de Barcelona (UAB), Bellaterra, Barcelona 08193, Spain.

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.

KEYWORDS:

Breast cancer; Colorectal cancer; Comorbidity; Lung cancer; Survival

PMID:
28586708
DOI:
10.1016/j.canep.2017.05.010
[Indexed for MEDLINE]

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