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Age and Co-Morbidity in Cancer Patients: A Population-Based Approach

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Biological Basis of Geriatric Oncology

Part of the book series: Cancer Treatment and Research ((CTAR,volume 124))

4. Conclusions

There is now clear evidence that the prevalence of co-morbidity among older cancer patients is high and that older patients (with comorbidity) are often treated less aggressively, which seems to have a negative influence on survival. However, would outcomes really improve if more patients were treated, according to the guidelines that were developed on the basis of results in groups of younger patients without co-morbidity? Would more complications occur in older patients with co-morbidity? If that is the case, is it possible to develop special treatment regimens for older cancer patients with co-morbidity and adapt the guidelines? It remains relevant to study the influence of age and co-morbidity on toxicity from treatment, quality of life and prognosis in unselected groups of patients.

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References

  1. Extermann M; Overcash J; Lyman GH; Parr J; Balducci L: Comorbidity and functional status are independent in older cancer patients. J Clin Oncol, 1998, 16:1582–1587

    PubMed  CAS  Google Scholar 

  2. Repetto L; Fratino L; Audisio RA; Venturino A; Gianni W; Vercelli M; Parodi S; Dal Lago D; Gioia F; Monfardini S; Aapro MS; Serraino D; Zagonel V: Comprehensive geriatric assessment adds information to Eastern Cooperative Oncology Group performance status in elderly cancer patients: an Italian Group for Geriatric Oncology Study. J Clin Oncol, 2002, 20:494–502

    Article  PubMed  Google Scholar 

  3. Yancik R; Ganz PA; Varricchio CG; Conley B: Perspectives on comorbidity and cancer in older patients: approaches to expand the knowledge base. J Clin Oncol, 2001, 19:1147–1151

    PubMed  CAS  Google Scholar 

  4. Coebergh JWW; Janssen-Heijnen MLG; Post PN; Razenberg PPA: Serious co-morbidity among unselected cancer patients newly diagnosed in the southeastern part of the Netherlands in 1993–1996. J Clin Epidemiol, 1999, 52:1131–1136

    Article  PubMed  CAS  Google Scholar 

  5. Coebergh JWW; Janssen-Heijnen MLG; Louwman WJ; Voogd AC eds: Cancer incidence, care and survival in the South of the Netherlands, 1955–1999: a report of the Eindhoven Cancer Registry with cross-border implications. Eindhoven: Comprehensive Cancer Centre South (IKZ), 2001

    Google Scholar 

  6. Charlson ME; Pompei P; Ales KL; MacKenzie CR: A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis, 1987, 40:373–383

    Article  PubMed  CAS  Google Scholar 

  7. Kieszak SM; Flanders WD; Kosinski AS; Shipp CC; Karp H: A comparison of the Charlson comorbidity index derived from medical record data and administrative billing data. J Clin Epidemiol, 1999, 52:137–142

    Article  PubMed  CAS  Google Scholar 

  8. Hakulinen T; Abeywickrama KH: A computer program package for relative survival analysis. Comput Programs Biomed, 1985, 19:197–207

    Article  PubMed  CAS  Google Scholar 

  9. Kaplan MH; Feinstein AR: The importance of classifying initial co-morbidity in evaluating the outcome of diabetes mellitus. J Chronic Dis, 1974, 27:387–404

    Article  PubMed  CAS  Google Scholar 

  10. Yancik R; Wesley MN; Ries LA; Havlik RJ; Long S; Edwards BK; Yates JW: Comorbidity and age as predictors of risk for early mortality of male and female colon carcinoma patients: a population-based study. Cancer, 1998, 82:2123–2134

    Article  PubMed  CAS  Google Scholar 

  11. Miller MD; Paradis CF; Houck PR; Mazumdar S; Stack JA; Rifai AH; Mulsant B; Reynolds CF, 3rd: Rating chronic medical illness burden in geropsychiatric practice and research: application of the Cumulative Illness Rating Scale. Psychiatry Res, 1992, 41:237–248

    Article  PubMed  CAS  Google Scholar 

  12. Greenfield S; Blanco DM; Elashoff RM; Ganz PA: Patterns of care related to age of breast cancer patients. JAMA, 1987, 257:2766–2770

    Article  PubMed  CAS  Google Scholar 

  13. Janssen-Heijnen MLG; Smulders S; Lemmens VEPP; Smeenk FWJM; Coebergh JWW: Do age and comorbidity in unselected patients with small cell lung cancer influence treatment chosen and prognosis? Submitted

    Google Scholar 

  14. Koppert LB; Janssen-Heijnen MLG; Louwman WJ; Lemmens VEPP; Wijnhoven BPL; Tilanus HW; Coebergh JWW: Comparison of comorbidity prevalence in oesophageal and gastric carcinoma patients: a population-based study. Eur J Gastrol Hepatol (2004 in press)

    Google Scholar 

  15. Janssen-Heijnen MLG; Schipper RM; Razenberg PPA; Crommelin MA; Coebergh JWW: Prevalence of co-morbidity in lung cancer patients and its relationship with treatment: a population-based study. Lung Cancer, 1998, 21:105–113

    Article  PubMed  CAS  Google Scholar 

  16. Jain M; Howe GR; St Louis P; Miller AB: Coffee and alcohol as determinants of risk of pancreas cancer: a case-control study from Toronto. Int J Cancer, 1991, 47:384–389

    PubMed  CAS  Google Scholar 

  17. Kalapothaki V; Tzonou A; Hsieh CC; Toupadaki N; Karakatsani A; Trichopoulos D: Tobacco, ethanol, coffee, pancreatitis, diabetes mellitus, and cholelithiasis as risk factors for pancreatic carcinoma. Cancer Causes Control, 1993, 4:375–382

    Article  PubMed  CAS  Google Scholar 

  18. Parazzini F; La Vecchia C; Bocciolone L; Franceschi S: The epidemiology of endometrial cancer. Gynecol Oncol, 1991,41:1–16

    Article  PubMed  CAS  Google Scholar 

  19. McLaughlin JK; Chow WH; Mandel JS; Mellemgaard A; McCredie M; Lindblad P; Schlehofer B; Pommer W; Niwa S; Adami HO: International renal-cell cancer study. VIII. Role of diuretics, other anti-hypertensive medications and hypertension. Int J Cancer, 1995,63:216–221

    PubMed  CAS  Google Scholar 

  20. Houben MP; Louwman WJ; Tijssen CC; Teepen JL; Coebergh JW: Hypertension a risk factor for glioma? Evidence from a population-based study of comorbidity in glioma patients. Submitted

    Google Scholar 

  21. Lindblad P; Chow WH; Chan J; Bergstrom A; Wolk A; Gridley G; McLaughlin JK; Nyren O; Adami HO: The role of diabetes mellitus in the aetiology of renal cell cancer. Diabetologia, 1999,42:107–112

    Article  PubMed  CAS  Google Scholar 

  22. Janssen-Heijnen MLG; Smulders S; Lemmens VEPP; Smeenk FWJM; van Geffen HJAA; Coebergh JWW: Elderly non-small cell lung cancer patients with comorbidity are treated less aggressively, whereas comorbidity has little effect on prognosis. Submitted

    Google Scholar 

  23. Damhuis RA; Schutte PR: Resection rates and postoperative mortality in 7,899 patients with lung cancer. Eur Respir, 1996, J 9:7–10

    Article  CAS  Google Scholar 

  24. Finlayson EV; Birkmeyer JD: Operative mortality with elective surgery in older adults. Eff Clin Pract, 2001,4:172–177

    PubMed  CAS  Google Scholar 

  25. Bolliger CT; Jordan P; Soler M; Stulz P; Gradel E; Skarvan K; Elsasser S; Gonon M; Wyser C; Tamm M; et al: Exercise capacity as a predictor of postoperative complications in lung resection candidates. Am J Respir Crit Care Med, 1995, 151:1472–1480

    PubMed  CAS  Google Scholar 

  26. Post PN; Kil PJ; Hendrikx AJ; Janssen-Heijnen ML; Crommelin MA; Coebergh JW: Comorbidity in patients with prostate cancer and its relevance to treatment choice. BJU Int, 1999, 84:652–656

    Article  PubMed  CAS  Google Scholar 

  27. Lemmens VEPP; Janssen-Heijnen MLG; Verheij CDGW; Houterman S; Repelaer van Driel OJ; Coebergh JWW: Comorbidity leads to altered treatment and worse survival of elderly colorectal cancer patients: a population-based study. Submitted

    Google Scholar 

  28. Forman WB: The role of chemotherapy and adjuvant therapy in the management of colorectal cancer. Cancer, 1994, 74:2151–2153

    PubMed  CAS  Google Scholar 

  29. Stein BN; Petrelli NJ; Douglass HO; Driscoll DL; Arcangeli G; Meropol NJ: Age and sex are independent predictors of 5-fluorouracil toxicity. Analysis of a large-scale phase III trial. Cancer, 1995,75:11–17

    PubMed  CAS  Google Scholar 

  30. Zalcberg J; Kerr D; Seymour L; Palmer M: Haematological and non-haematological toxicity after 5-fluorouracil and leucovorin in patients with advanced colorectal cancer is significantly associated with gender, increasing age and cycle number. Tomudex International Study Group. Eur J Cancer, 1998, 34:1871–1875

    Article  PubMed  CAS  Google Scholar 

  31. van Spronsen DJ; Janssen-Heijnen MLG; Lemmens VEPP; Peters WG; Coebergh JWW: The independent prognostic effect of co-morbidity in lymphoma patients: results from the population-based Eindhoven Cancer Registry. Submitted

    Google Scholar 

  32. Louwman WJ; Janssen-Heijnen MLG; Houterman S; Voogd AC; Coebergh JWW: Less extensive treatment and lower survival in breast cancer patients with comorbidity: a population-based study. Submitted

    Google Scholar 

  33. Ayanian, JZ; Zaslavsky AM; Fuchs CS; Guadagnoli E; Creech CM; Cress RD; O’Connor LC; West DW; Allen ME; Wolf RE; Wright WE: Use of adjuvant chemotherapy and radiation therapy for colorectal cancer in a population-based cohort. J Clin Oncol, 2003, 21:1293–1300

    Article  PubMed  Google Scholar 

  34. Lash TL; Thwin SS; Horton NJ; Guadagnoli E; Silliman RA: Multiple informants: a new method to assess breast cancer patients’ comorbidity. Am J Epidemiol, 2003, 157:249–257

    Article  PubMed  Google Scholar 

  35. Satariano WA; Ragland DR: The effect of comorbidity on three-year survival of women with primary breast cancer. Ann Intern Med, 1994,120:104–110

    PubMed  CAS  Google Scholar 

  36. van Spronsen DJ; Janssen-Heijnen ML; Breed WP; Coebergh JW: Prevalence of comorbidity and its relationship to treatment among unselected patients with Hodgkin’s disease and non-Hodgkin’s lymphoma, 1993–1996. Ann Hematol, 1999, 78:315–319

    Article  PubMed  Google Scholar 

  37. de Rijke JM; Schouten LJ; Schouten HC; Jager JJ; Koppejan AG; van den Brandt PA: Age-specific differences in the diagnostics and treatment of cancer patients aged 50 years and older in the province of Limburg, The Netherlands. Ann Oncol, 1996, 7:677–685

    PubMed  Google Scholar 

  38. Battafarano RJ; Piccirillo JF; Meyers BF; Hsu HS; Guthrie TJ; Cooper JD; Patterson GA: Impact of comorbidity on survival after surgical resection in patients with stage I nonsmall cell lung cancer. J Thorac Cardiovasc Surg, 2002, 123:280–287

    Article  PubMed  Google Scholar 

  39. Firat S; Bousamra M; Gore E; Byhardt RW: Comorbidity and KPS are independent prognostic factors in stage I non-small-cell lung cancer. Int J Radiat Oncol Biol Phys, 2002,52:1047–1057

    Article  PubMed  Google Scholar 

  40. Firat S; Byhardt R; Gore E: Comorbidity and Karnofksy performance score are independent prognostic factors in stage III non-small-cell lung cancer: an institutional analysis of patients treated on four RTOG studies. Radiation Therapy Oncology Group. Int J Radiat Oncol Biol Phys, 2002, 54:357–364

    Article  PubMed  Google Scholar 

  41. Piccirillo JF: Importance of comorbidity in head and neck cancer. Laryngoscope, 2000, 110:593–602

    Article  PubMed  CAS  Google Scholar 

  42. Tammemagi CM; Neslund-Dudas C; Simoff M; Kvale P: Impact of comorbidity on lung cancer survival. Int J Cancer, 2003, 103:792–802

    Article  PubMed  CAS  Google Scholar 

  43. Post PN; Hansen BE; Kil PJ; Janssen-Heijnen ML; Coebergh JW: The independent prognostic value of comorbidity among men aged < 75 years with localized prostate cancer: a population-based study. BJU Int, 2001, 87:821–826.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Eindhoven Cancer Registry at Comprehensive Cancer Center South (IKZ), 5600 AE, Eindhoven, The Netherlands

    Maryska L. G. Janssen-Heijnen (Senior Researcher), Saskia Houterman (Staff Researcher), Valery E. P. P. Lemmens (Junior Researcher) & Marieke W. J. Louwman (Senior Researcher)

  2. Department of Public Health, Erasmus University Medical Centre Rotterdam, 3000 DR, Rotterdam, The Netherlands

    Jan Willem W. Coebergh (Head of Research and Professor)

Authors
  1. Maryska L. G. Janssen-Heijnen
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  2. Saskia Houterman
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  3. Valery E. P. P. Lemmens
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  4. Marieke W. J. Louwman
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  5. Jan Willem W. Coebergh
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Editors and Affiliations

  1. University of South Florida College of Medicine, Tampa, Florida, USA

    Lodovico Balducci MD (Professor of Oncology and Medicine and Program Leader) & Martine Extermann MD, PhD (Associate Professor of Oncology and Medicine) (Professor of Oncology and Medicine and Program Leader) &  (Associate Professor of Oncology and Medicine)

  2. Senior Adult Oncology Program, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA

    Lodovico Balducci MD (Professor of Oncology and Medicine and Program Leader) & Martine Extermann MD, PhD (Associate Professor of Oncology and Medicine) (Professor of Oncology and Medicine and Program Leader) &  (Associate Professor of Oncology and Medicine)

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Janssen-Heijnen, M.L.G., Houterman, S., Lemmens, V.E.P.P., Louwman, M.W.J., Coebergh, J.W.W. (2005). Age and Co-Morbidity in Cancer Patients: A Population-Based Approach. In: Balducci, L., Extermann, M. (eds) Biological Basis of Geriatric Oncology. Cancer Treatment and Research, vol 124. Springer, Boston, MA. https://doi.org/10.1007/0-387-23962-6_5

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  • DOI: https://doi.org/10.1007/0-387-23962-6_5

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-0-387-23961-3

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