Journal of Cancer Survivorship

, Volume 9, Issue 2, pp 239–251 | Cite as

The complex health profile of long-term cancer survivors: prevalence and predictors of comorbid conditions

  • Corinne R. Leach
  • Kathryn E. Weaver
  • Noreen M. Aziz
  • Catherine M. Alfano
  • Keith M. Bellizzi
  • Erin E. Kent
  • Laura P. Forsythe
  • Julia H. Rowland



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.


Cancer 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.


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Copyright information

© Springer Science+Business Media New York (outside the USA) 2014

Authors and Affiliations

  • Corinne R. Leach
    • 1
  • Kathryn E. Weaver
    • 2
  • Noreen M. Aziz
    • 3
  • Catherine M. Alfano
    • 4
  • Keith M. Bellizzi
    • 5
  • Erin E. Kent
    • 4
  • Laura P. Forsythe
    • 6
  • Julia H. Rowland
    • 4
  1. 1.Behavioral Research CenterAmerican Cancer SocietyAtlantaUSA
  2. 2.Department of Social Sciences & Health PolicyWake Forest University School of MedicineWinston-SalemUSA
  3. 3.National Institute of Nursing ResearchNational Institutes of HealthBethesdaUSA
  4. 4.Division of Cancer Control and Population Sciences, National Cancer InstituteNational Institutes of HealthBethesdaUSA
  5. 5.Department of Human Development and Family StudiesUniversity of ConnecticutStorrsUSA
  6. 6.Patient-Centered Outcomes Research InstituteWashington DCUSA

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