Health Economics and Policy Research, Centre for Health, Informatics and Economic Research, University of Southern Queensland, Toowoomba, Queensland, Australia.
School of Commerce, University of Southern Queensland, Toowoomba, Queensland, Australia.
PLoS One. 2020 Feb 12;15(2):e0228744. doi: 10.1371/journal.pone.0228744. eCollection 2020.
Cancer is a major public health concern in terms of morbidity and mortality worldwide. Several types of cancer patients suffer from chronic comorbid conditions that are a major clinical challenge for treatment and cancer management. The main objective of this study was to investigate the distribution of the burden of chronic comorbid conditions and associated predictors among cancer patients in Australia over the period of 2007-2017.
The study employed a prospective longitudinal design using data from the Household, Income and Labour Dynamics in Australia survey. The number of chronic comorbid conditions was measured for each respondent. The longitudinal effect was captured using a fixed-effect negative binomial regression model, which predicted the potential factors that played a significant role in the occurrence of chronic comorbid conditions.
Sixty-one percent of cancer patients experienced at least one chronic disease over the period, and 21% of patients experienced three or more chronic diseases. Age (>65 years old) (incidence rate ratio, IRR = 1.15; 95% confidence interval, CI: 1.05, 1.40), inadequate levels of physical activity (IRR = 1.25; 95% CI: 1.09, 1.59), patients who suffered from extreme health burden (IRR = 2.30; 95% CI: 1.73, 3.05) or moderate health burden (IRR = 1.90; 95% CI: 1.45, 2.48), and patients living in the poorest households (IRR = 1.21; 95% CI: 1.11, 1.29) were significant predictors associated with a higher risk of chronic comorbid conditions.
A large number of cancer patients experience an extreme burden of chronic comorbid conditions and the different dimensions of these in cancer survivors have the potential to affect the trajectory of their cancer burden. It is also significant for health care providers, including physical therapists and oncologists, who must manage the unique problems that challenge this population and who should advocate for prevention and evidence-based interventions.
癌症是一个重大的公共卫生问题，在全球范围内与发病率和死亡率有关。许多类型的癌症患者患有慢性合并症，这对治疗和癌症管理构成了重大的临床挑战。本研究的主要目的是调查 2007-2017 年期间澳大利亚癌症患者慢性合并症负担的分布情况及其相关预测因素。
本研究采用前瞻性纵向设计，使用澳大利亚家庭、收入和劳动力动态调查的数据。为每位受访者测量了慢性合并症的数量。使用固定效应负二项回归模型捕捉纵向效应，该模型预测了在慢性合并症发生中起重要作用的潜在因素。
在研究期间，61%的癌症患者至少患有一种慢性病，21%的患者患有三种或更多种慢性病。年龄（>65 岁）（发病率比，IRR=1.15；95%置信区间，CI：1.05，1.40）、身体活动不足（IRR=1.25；95%CI：1.09，1.59）、健康负担过重的患者（IRR=2.30；95%CI：1.73，3.05）或中度健康负担（IRR=1.90；95%CI：1.45，2.48）以及生活在最贫困家庭的患者（IRR=1.21；95%CI：1.11，1.29）与慢性合并症发生风险较高显著相关。
大量癌症患者患有严重的慢性合并症负担，癌症幸存者中这些合并症的不同维度有可能影响其癌症负担的轨迹。这对包括物理治疗师和肿瘤学家在内的医疗保健提供者也具有重要意义，他们必须管理这一人群面临的独特问题，并倡导预防和基于证据的干预措施。
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