The complex health profile of long-term cancer survivors: prevalence and predictors of comorbid conditions
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Adult cancer survivors have complex medical profiles that may include chronic conditions beyond cancer. Few studies have examined the prevalence of comorbidities before and after a cancer diagnosis.
Cancer cases were sampled from two California cancer registries to examine medical conditions (ever experienced and developed after cancer) among 1,527 long-term breast, prostate, colorectal, and gynecological cancer survivors by socio-demographic, cancer-related, and health behavior variables.
On average, survivors reported five medical conditions ever diagnosed (95 % CI, 4.8, 5.1) and 1.9 conditions (95 % CI, 1.8, 2.0) diagnosed after cancer. Breast cancer survivors reported the highest (5.8 ever, 2.9 post-cancer) and prostate survivors the lowest (4.0 ever, 1.0 post-cancer) comorbidity burden. Higher comorbidity burden was associated with older age, being a breast cancer survivor, divorced, widowed or separated, non-Hispanic White, overweight or obese, and not receiving chemotherapy. Breast and endometrial cancer survivors, as well as those more than 10 years post-diagnosis, obese, or physically inactive were more likely to report that these comorbidities occurred after cancer. Cancer treatment type, smoking, age, race/ethnicity, marital status, and education were not significant predictors of comorbidities acquired post-cancer.
Cancer survivors report a large number of medical conditions, many identified after a cancer diagnosis. Findings suggest that time since cancer diagnosis, body mass index, and activity level are important contextual variables when managing survivor’s post-treatment follow-up care.
Implications for Cancer Survivors
Survivors may benefit when health professionals recommend specific strategies to achieve a healthy weight and regular physical activity for better long-term health outcomes after cancer.
KeywordsCancer survivor Chronic disease Comorbidity Multimorbidity
The views expressed in this paper are those of the authors and do not necessarily reflect the views of the American Cancer Society, the Federal Government, or the Patient-Centered Outcomes Research Institute. This study was supported by the National Cancer Institute at the National Institutes of Health contracts No. N01-PC-35136 and HHSN 261201100189P. The authors would like to acknowledge: Dr. Neeraj Arora (NCI) for his survey development work and guidance, Dr. Arti Hurria (City of Hope) for her clinical expertise and assistance in categorizing medical conditions, and Dr. Ann Hamilton and Dr. Ingrid Oakley-Girvan for their oversight of the FOCUS study at their respective centers. The authors would also like to acknowledge Ms. Gretchen Keel and Mr. Todd Gibson (Information Management Services, Inc., Rockville, MD) for their assistance with data analysis on this project.
Disclosure of funding
This study was supported by the National Cancer Institute at the National Institutes of Health contracts No. N01-PC-35136 and HHSN 261201100189P. There are no financial disclosures for any authors.
Conflict of interest
Authors Corinne Leach, Kathryn Weaver, Noreen Aziz, Catherine Alfano, Keith Bellizzi, Erin Kent, Laura Forsythe, and Julia Rowland declare they have no conflict of interest.
- 2.Parry C, Kent EE, Mariotto AB, Alfano CM, Rowland JH. Cancer survivors: a booming population. Cancer epidemiology, biomarkers & prevention: a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology. 2011;20 (10):1996–2005Google Scholar
- 4.Braithwaite D, Moore DH, Satariano WA, Kwan ML, Hiatt RA, Kroenke C, et al. Prognostic impact of comorbidity among long-term breast cancer survivors: results from the LACE study. Cancer epidemiology, biomarkers & prevention: a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology. 2012;21 (7):1115–25Google Scholar
- 10.Weaver KE, Forsythe LP, Reeve BB, Alfano CM, Rodriguez JL, Sabatino SA. Mental and physical health-related quality of life among U.S. cancer survivors: population estimates from the 2010 National Health Interview Survey. Cancer Epidemiology Biomarkers Prevention. 2012;21(11):2108–17.CrossRefGoogle Scholar
- 11.Smith AW, Reeve BB, Bellizzi KM, Harlan LC, Klabunde CN, Amsellem M, et al. Cancer, comorbidities, and health-related quality of life of older adults. J Health Care Finance. 2008;29(4):41–56.Google Scholar
- 12.Grov EK, Fossa SD, Dahl AA. Short-term and long-term elderly cancer survivors: a population-based comparative and controlled study of morbidity, psychosocial situation, and lifestyle. European Journal of Oncology Nursing: the official Journal of European Oncology Nursing Society. 2011;15(3):213–20.CrossRefGoogle Scholar
- 17.Danese MD, O'Malley C, Lindquist K, Gleeson M, Griffiths RI. An observational study of the prevalence and incidence of comorbid conditions in older women with breast cancer. Annals of Oncology: official Journal of the European Society for Medical Oncology/ESMO. 2012;23(7):1756–65.CrossRefGoogle Scholar
- 32.Eyre H, Kahn R, Robertson RM, Clark NG, Doyle C, Hong Y, et al. Preventing cancer, cardiovascular disease, and diabetes: a common agenda for the American Cancer Society, the American Diabetes Association, and the American Heart Association: stroke. J cerebral circ. 2004;35(8):1999–2010.CrossRefGoogle Scholar
- 37.Weaver KE, Aziz NM, Arora NK, Forsythe LP, Hamilton AS, Oakley-Girvan I, et al. Follow-up care experiences and perceived quality of care among long-term survivors of breast, prostate, colorectal, and gynecologic cancers. Journal of Oncology Practice/American Society of Clinical Oncology 2014Google Scholar