Warner David F, Schiltz Nicholas K, Stange Kurt C, Given Charles W, Owusu Cynthia, Berger Nathan A, Koroukian Siran M
Department of Sociology, 711 Oldfather Hall, University of Nebraska-Lincoln, 1400 R St., Lincoln, NE 68588, USA.
Department of Epidemiology and Biostatistics, School of Medicine, Wood Building, Case Western Reserve University, 10900 Euclid Ave., Cleveland, OH 44106, USA.
Fam Med Community Health. 2017 Jul;5(2):129-138. doi: 10.15212/FMCH.2017.0127.
To characterize complex multimorbidity among cancer survivors and evaluate the association between cancer survivorship, time since cancer diagnosis, and self-reported fair/poor health, self-rated worse health in 2 years, and 2-year mortality.
We used the 2010-2012 Health and Retirement Study. Cancer survivors were individuals who reported a (nonskin) cancer diagnosis 2 years or more before the interview. We defined complex multimorbidity as the co-occurrence of chronic conditions, functional limitations, and/or geriatric syndromes. In addition to descriptive analyses, we used logistic regression to evaluate the independent association between cancer survivor status and health outcomes. We also examined whether cancer survivorship differed by the number of years since diagnosis.
Among 15,808 older adults (age ≥50 years), 11.8% were cancer survivors. Compared with cancer-free individuals, a greater percentage of cancer survivors had complex multimorbidity: co-occurring chronic conditions, functional limitations, and geriatric syndromes. Cancer survivorship was significantly associated with self-reported fair/poor health, self-rated worse health in 2 years, and 2-year mortality. These effects declined with the number of years since diagnosis for fair/ poor health and mortality but not for self-rated worse health.
Cancer survivor status is independently associated with more complex multimorbidity, and with worse health outcomes. These effects attenuate with time, except for patient perception of being in worse health.
描述癌症幸存者中的复杂多重疾病状况，并评估癌症幸存者身份、癌症诊断后的时间与自我报告的健康状况一般/较差、自我评估的两年内健康状况变差以及两年死亡率之间的关联。
我们使用了2010 - 2012年健康与退休研究。癌症幸存者是指在访谈前两年或更早报告（非皮肤）癌症诊断的个体。我们将复杂多重疾病定义为慢性病、功能受限和/或老年综合征的共同出现。除了描述性分析外，我们使用逻辑回归来评估癌症幸存者状态与健康结果之间的独立关联。我们还研究了癌症幸存者身份是否因诊断后的年数不同而有所差异。
在15808名年龄≥50岁的老年人中，11.8%是癌症幸存者。与无癌症个体相比，更高比例的癌症幸存者患有复杂多重疾病：同时存在慢性病、功能受限和老年综合征。癌症幸存者身份与自我报告的健康状况一般/较差、自我评估的两年内健康状况变差以及两年死亡率显著相关。对于健康状况一般/较差和死亡率，这些影响随着诊断后的年数增加而减弱，但对于自我评估的健康状况变差则不然。
癌症幸存者身份与更复杂的多重疾病独立相关，且与更差的健康结果相关。除了患者对自身健康状况变差的感知外，这些影响会随着时间减弱。
