Late Effect Research Unit CASTLE, Department of Oncology, Rigshospitalet, Blegdamsvej 58, 9601, 2100, Copenhagen, Denmark.
Psychological Aspects of Cancer, Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark.
Br J Cancer. 2020 Sep;123(6):1033-1040. doi: 10.1038/s41416-020-0950-3. Epub 2020 Jul 7.
Multimorbidity is a growing challenge worldwide. In this nationwide study, we investigated the prevalence of multimorbidity and polypharmacy at the time of diagnosis across 20 cancers.
We conducted a nationwide register-based cohort study of all Danish residents with a first primary cancer diagnosed between 1 January 2005 and 31 December 2015. Multimorbidity was defined as one or more of 20 conditions (131 specific diagnoses) registered in the Danish National Patient Registry < 5 years before the cancer diagnosis. Polypharmacy was defined as five or more medications registered in the Danish National Prescription Registry and redeemed twice 2-12 months before the cancer diagnosis.
We included 261,745 patients with a first primary cancer, of whom 55% had at least one comorbid condition at diagnosis and 27% had two or more. The most prevalent conditions at the time of cancer diagnosis were cardiovascular disease, chronic obstructive pulmonary disease, diabetes, stroke and depression/anxiety disorder. Polypharmacy was present in one-third of the cancer patients with antihypertensives, anti-thrombotic agents, anti-hyperlipidaemic agents, analgesics and diuretics as the most prevalent redeemed medications.
Among patients with a newly established cancer diagnosis, 55% had at least one comorbid condition and 32% were exposed to polypharmacy.
全球范围内，多种疾病共存的情况日益严峻。本项全国性研究旨在调查 20 种癌症确诊时的多种疾病共存和多种药物并用的流行率。
我们开展了一项全国性基于登记的队列研究，纳入了所有于 2005 年 1 月 1 日至 2015 年 12 月 31 日期间首次确诊原发性癌症的丹麦居民。多种疾病共存定义为在癌症确诊前的 5 年内登记的 20 种疾病（131 种特定诊断）中的一种或多种。多种药物并用定义为在丹麦国家处方登记处登记的 5 种或更多药物，且在癌症确诊前的 2-12 个月内，该药物的使用记录达到两次。
我们纳入了 261745 名首次确诊原发性癌症的患者，其中 55%的患者在确诊时至少有一种合并症，27%的患者有两种或以上合并症。癌症确诊时最常见的疾病包括心血管疾病、慢性阻塞性肺疾病、糖尿病、中风和抑郁/焦虑障碍。在接受降压药、抗血栓药、抗高血脂药、镇痛药和利尿剂治疗的癌症患者中，有三分之一存在多种药物并用的情况。
在新确诊癌症的患者中，55%的患者至少有一种合并症，32%的患者存在多种药物并用的情况。
