Koroukian Siran M, Murray Patrick, Madigan Elizabeth
Division of Health Policy, Department of Epidemiology and Biostatistics, School of Medicine, Case Western Reserve University and the Center for Health Care Research, Cleveland, OH 44106-4945, USA.
J Clin Oncol. 2006 May 20;24(15):2304-10. doi: 10.1200/JCO.2005.03.1567.
To assess the prevalence of comorbidity, disability, and geriatric syndromes, or a combination thereof, in elders with cancer receiving home health care (HHC).
Using the Ohio Cancer Incidence Surveillance System, we identified Ohio residents 65 years of age or older who were diagnosed with incident breast (n = 952), prostate (n = 324), or colorectal cancer (n = 1,276) during the 28-month study period, August 1999 through November 2001. We used the Outcome and Assessment Information Set, a database compiling comprehensive assessment forms completed for all HHC patients, to group individuals in independent and overlapping categories of comorbidity, disability, and geriatric syndromes on the basis of the patients' clinical condition 14 days before the date of the assessment.
The proportion with no comorbidity, disability, or geriatric syndromes was 26.4% in breast cancer patients, 12.0% in prostate cancer patients, and 14.0% in colorectal cancer patients. The proportion of patients presenting all three entities at once was 11.7%, 24.7%, and 15.7%, respectively, in three cancer sites. As expected, the proportion of patients with no comorbidity, disability, or geriatric syndromes declined gradually with increasing age, and that of patients with all three entities was highest among patients 85 years or older.
The proposed taxonomy will help us gain a more nuanced understanding of older cancer patients' clinical presentation and may lead to a more accurate identification of older patients who might benefit from standard cancer treatment, and those who might experience adverse outcomes.
评估接受家庭保健（HHC）的老年癌症患者中合并症、残疾和老年综合征或其组合的患病率。
利用俄亥俄州癌症发病率监测系统，我们确定了1999年8月至2001年11月这28个月研究期间，俄亥俄州65岁及以上被诊断为新发乳腺癌（n = 952）、前列腺癌（n = 324）或结直肠癌（n = 1276）的居民。我们使用结果与评估信息集，这是一个汇编了为所有HHC患者填写的综合评估表的数据库，根据评估日期前14天患者的临床状况，将个体分为合并症、残疾和老年综合征的独立和重叠类别。
乳腺癌患者中无合并症、残疾或老年综合征的比例为26.4%，前列腺癌患者为12.0%，结直肠癌患者为14.0%。在三个癌症部位，同时出现所有三种情况的患者比例分别为11.7%、24.7%和15.7%。正如预期的那样，无合并症、残疾或老年综合征的患者比例随着年龄增长逐渐下降，而同时出现所有三种情况的患者比例在85岁及以上患者中最高。
所提出的分类法将有助于我们更细致地了解老年癌症患者的临床表现，并可能导致更准确地识别可能从标准癌症治疗中获益的老年患者以及可能出现不良结局的患者。
