Does the timing of comorbidity affect colorectal cancer survival? A population based study.


Shack, LG; Rachet, B; Williams, EM; Northover, JM; Coleman, MP; (2010) Does the timing of comorbidity affect colorectal cancer survival? A population based study. Postgraduate medical journal, 86 (1012). pp. 73-8. ISSN 0032-5473 DOI: 10.1136/pgmj.2009.084566

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Abstract

OBJECTIVES: Comorbid conditions in colorectal cancer patients can influence both clinical eligibility for treatment and survival. We aimed to evaluate the effect of comorbidity on 1 year survival from colorectal cancer, and to assess whether this effect varied with the timing of the comorbidity in relation to the cancer diagnosis. STUDY DESIGN AND SETTING: A population based cohort of 29,563 colorectal cancer patients diagnosed between 1997 and 2004 in the North West of England was evaluated. The excess hazard of death up to 1 year after diagnosis was estimated using deprivation and region specific life tables to adjust for background mortality. Results were adjusted for age and stage at diagnosis. RESULTS: Comorbid conditions diagnosed during the period 18 to 6 months before the diagnosis of colorectal cancer were strongly associated with lower survival at 1 year. Stage and age remained the strongest predictors of cancer related mortality even after adjustment for comorbidity. CONCLUSIONS: Administrative data provide a good estimate of the prevalence of most comorbid conditions but may be biased for some comorbid conditions that can be contra-indicators for cancer treatment. The time window in which a comorbid condition occurs in relation to the cancer diagnosis should be taken into account. Adjustment should be carried out, where possible, to provide more robust and clinically appropriate comparisons of population based cancer patient survival.

Item Type: Article
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Non-Communicable Disease Epidemiology
Research Centre: Cancer Survival Group
Centre for Global Non-Communicable Diseases (NCDs)
PubMed ID: 20145054
Web of Science ID: 274426400004
URI: http://researchonline.lshtm.ac.uk/id/eprint/4059

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