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Chronic disease burden among cancer survivors in the California Behavioral Risk Factor Surveillance System, 2009–2010

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Abstract

Purpose

The California Behavioral Risk Factor Surveillance System estimates that 56.6 % of cancer survivors report ever being diagnosed with a chronic disease. Few studies have assessed potential variability in comorbidity by cancer type.

Methods

We used data collected from a representative sample of adult participants in the 2009 and 2010 California Behavioral Risk Factor Surveillance System (n = 18,807). Chronic diseases were examined with cancer survivorship in case/non-case and case/case analyses. Prevalence ratios (PR) and corresponding 95 % confidence intervals (95 % CI) were estimated using Cox proportional hazards models, with adjustment on race, sex, age, education, smoking, and drinking.

Results

Obesity was associated with gynecological cancers (PR 1.74; 95 % CI 1.26–2.41), and being overweight was associated with gynecological (PR 1.40; 95 % CI 1.05–1.86) and urinary (PR 2.19; 95 % CI 1.21–3.95) cancers. Arthritis was associated with infection-related (PR 1.78; 95 % CI 1.12–2.83) and hormone-related (PR 1.20; 95 % CI 1.01–1.42) cancers. Asthma was associated with infection- (PR 2.26; 95 % CI 1.49–3.43), hormone- (PR 1.46; 95 % CI 1.21–1.77), and tobacco- (PR 1.86; 95 % CI 1.25–2.77) related cancers. Chronic obstructive pulmonary disease (COPD) was associated with infection- (PR 2.16; 95 % CI 1.22–3.83) and tobacco-related (PR 2.24; 95 % CI 1.37–3.66) cancers and with gynecological cancers (PR 1.60; 95 % 1.00–2.56).

Conclusions

This is the first study to examine chronic disease burden among cancer survivors in California. Our findings suggest that the chronic disease burden varies by cancer etiology.

Implications for Cancer Survivors

A clear need has emerged for future biological and epidemiological studies of the interaction between chronic disease and cancer etiology in survivors.

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Acknowledgement

We would like to recognize and thank the participants in the 2009 and 2010 California BRFSS. This study would not have been possible without their valuable time and willingness to share personal information. We also thank Chaoyang Li (Centers for Disease Control and Prevention, National Center for Environmental Health) for feedback on our statistical approach to the analysis.

Conflict of interest

The authors declare that they have no financial or non-financial conflict of interest.

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Authors and Affiliations

  1. Department of Health and Human Sciences, Affiliate Faculty, The Bioethics Institute, Loyola Marymount University, 1 LMU Drive, MS 8160, Los Angeles, CA, USA

    Heather P. Tarleton

  2. Survey Research Group, Public Health Institute, Sacramento, CA, USA

    Suzanne Ryan-Ibarra & Marta Induni

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  1. Heather P. Tarleton
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Correspondence to Heather P. Tarleton.

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Heather P. Tarleton and Suzanne Ryan-Ibarra contributed equally toward this work.

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Tarleton, H.P., Ryan-Ibarra, S. & Induni, M. Chronic disease burden among cancer survivors in the California Behavioral Risk Factor Surveillance System, 2009–2010. J Cancer Surviv 8, 448–459 (2014). https://doi.org/10.1007/s11764-014-0350-x

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