University College London, 1-19 Torrington Place, London WC1E 6BT, UK; National Cancer Registration and Analysis Service, Public Health England, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, UK.
National Cancer Registration and Analysis Service, Public Health England, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, UK; Cancer Research UK, 2 Redman Place, London, E20 1JQ, UK.
Cancer Epidemiol. 2020 Dec;69:101845. doi: 10.1016/j.canep.2020.101845. Epub 2020 Nov 20.
Pre-existing chronic conditions (morbidities) influence the diagnosis and management of cancer. The prevalence of specific morbidities in patients diagnosed with common and rarer cancers is inadequately described.
Using data from the English National Cancer Diagnosis Audit 2014, we studied 11 pre-existing morbidities recorded as yes/no items by participating general practitioners based on information included in primary care records. We examined the number and type of morbidities across socio-demographic and cancer site strata, and subsequently estimated observed and age/sex standardised prevalence of each morbidity by cancer.
Over three-quarters (77 %; 11,429/14,774) of non-screen-detected patients had at least one chronic condition before diagnosis, while nearly half (47 %) had two or more. Hypertension (39 %) and physical disability (2%) were the most and least common conditions. Male, older and more socio-economically deprived patients were more likely to have at least one morbidity (p < 0.001 for all between variable group comparisons). For most morbidities, the standardised prevalence was similar across different cancers with a few exceptions, including respiratory disease prevalence being greatest among lung cancer patients and diabetes prevalence being greatest among liver, pancreatic, and endometrial cancer patients.
Most cancer patients have at least one morbidity, while almost one in two have two or more. The findings highlight the need to take certain morbidity- and cancer-site combinations into account when examining associations between morbidity and cancer outcomes.
先前存在的慢性疾病(合并症)会影响癌症的诊断和治疗。患有常见和罕见癌症的患者中,特定合并症的患病率描述不足。
利用来自 2014 年英国国家癌症诊断审计的数据,我们研究了 11 种先前存在的合并症,这些合并症是由参与的全科医生根据初级保健记录中的信息作为是/否项目记录的。我们考察了不同社会人口学和癌症部位分层中合并症的数量和类型,随后根据癌症类型,估计了每种合并症的观察到的和年龄/性别标准化的患病率。
在未经筛查发现的患者中,超过四分之三(77%;11429/14774)在诊断前至少有一种慢性疾病,而近一半(47%)有两种或更多。高血压(39%)和身体残疾(2%)是最常见和最不常见的疾病。男性、年龄较大和社会经济地位较低的患者更有可能患有至少一种合并症(所有变量组间比较均 p < 0.001)。对于大多数合并症,不同癌症之间的标准化患病率相似,但也有一些例外,包括在肺癌患者中呼吸系统疾病的患病率最高,在肝癌、胰腺癌和子宫内膜癌患者中糖尿病的患病率最高。
大多数癌症患者至少有一种合并症,而几乎有二分之一的患者有两种或更多合并症。这些发现强调了在研究合并症与癌症结果之间的关联时,需要考虑某些合并症和癌症部位的组合。