Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Cancer Epidemiology Group, University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Cancer. 2021 Apr 1;127(7):1154-1160. doi: 10.1002/cncr.33363. Epub 2020 Dec 1.
The number of elderly cancer survivors is growing because of increasing survival rates. A high comorbidity burden in the elderly can affect their quality of life and survival. The aim of this study was to examine whether breast cancer survivors and population-based controls have a different comorbidity burden after long-term follow-up.
This study used data from a German breast cancer case-control study, which initially comprised 3813 breast cancer cases aged 50 to 74 years who were diagnosed between 2002 and 2005 and 7341 population-based controls. Participants were followed up in 2014/2016. A modified Charlson Comorbidity Index (mCCI) was calculated to quantify severe comorbidities. Negative binomial regression was performed to estimate rate ratios (RRs) with 95% confidence intervals (CIs) for the association between case-control status and mCCI (dependent variable) for the baseline population and for those who participated at follow-up, with adjustments made for relevant lifestyle factors.
In total, 1925 cases and 3674 controls participated in the follow-up 12 years after recruitment. In the baseline population 35% had at least 1 comorbid condition.In long-term survivors this proportion was 52%. No difference was found in the mCCI between breast cancer cases and controls at baseline (RR, 1.05; 95% CI, 0.98-1.11) or between long-term survivors of the 2 groups at baseline (RR, 1.07; 95% CI, 0.97-1.18) or at follow-up (RR, 1.00; 95% CI, 0.91-1.10).
The comorbidity burden of long-term breast cancer survivors and controls increased over time; however, it remained similar in both groups after 12 years of follow-up.
由于存活率的提高，老年癌症幸存者的数量不断增加。老年人的高合并症负担会影响他们的生活质量和生存。本研究旨在探讨长期随访后，乳腺癌幸存者和基于人群的对照组是否具有不同的合并症负担。
本研究使用了一项德国乳腺癌病例对照研究的数据，该研究最初包括 3813 名年龄在 50 至 74 岁之间的乳腺癌患者，这些患者于 2002 年至 2005 年间确诊，并招募了 7341 名基于人群的对照组。参与者于 2014/2016 年进行了随访。计算改良 Charlson 合并症指数（mCCI）以量化严重合并症。使用负二项回归分析来估计病例对照状态与 mCCI（因变量）之间的比率比（RR）及其 95%置信区间（CI），用于基线人群和随访时参与的人群，调整了相关生活方式因素。
共有 1925 例病例和 3674 例对照组参加了招募后 12 年的随访。在基线人群中，有 35%的人至少有 1 种合并症。在长期幸存者中，这一比例为 52%。在基线时，乳腺癌病例与对照组之间的 mCCI 无差异（RR，1.05；95%CI，0.98-1.11），或两组长期幸存者之间的 mCCI 无差异（RR，1.07；95%CI，0.97-1.18），或在随访时（RR，1.00；95%CI，0.91-1.10）。
长期乳腺癌幸存者和对照组的合并症负担随时间推移而增加；然而，在 12 年的随访后，两组之间的负担仍然相似。
