Assessment and interpretation of comorbidity burden in older adults with cancer.

OBJECTIVES

To evaluate the associations between comorbidities, functional limitations, geriatric syndromes, treatment patterns, and outcomes in a population-based cohort of older patients diagnosed with colorectal cancer and receiving home health care.

DESIGN

Retrospective study.

SETTING

Data from the Ohio Cancer Incidence Surveillance System, Medicare claims and enrollment files, and the home health care Outcome and Assessment Information Set.

PARTICIPANTS

Ohio residents diagnosed with incident colorectal cancer in 1999 to 2001 and receiving home health care in the 30 days before or after cancer diagnosis (N=957).

MEASUREMENTS

Outcome measures included receipt of cancer treatment and survival through 2005.

RESULTS

Not having surgery was associated negatively with comorbidities but positively with functional limitations and geriatric syndromes. Receipt of chemotherapy was negatively associated with comorbidities and functional limitations. The presence of two or more geriatric syndromes was significantly associated with unfavorable survival outcomes when analyzing overall survival and disease-specific survival (DSS). Having limitations in two or more activities of daily living was associated with unfavorable overall survival but not with DSS. Comorbity was associated with favorable DSS at borderline level of statistical significance but not with overall survival.

CONCLUSION

The findings highlight the importance of incorporating functional limitations and geriatric syndrome data in geriatric oncology outcomes studies.