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美国成年癌症幸存者的慢性共病状况:来自 2002-2018 年全国健康访谈调查的结果。

Chronic comorbid conditions among adult cancer survivors in the United States: Results from the National Health Interview Survey, 2002-2018.

机构信息

Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, New York.

Department of Medicine, Mount Sinai Morningside/Mount Sinai West, Icahn School of Medicine at Mount Sinai, New York, New York.

出版信息

Cancer. 2022 Feb 15;128(4):828-838. doi: 10.1002/cncr.33981. Epub 2021 Oct 27.

Abstract

BACKGROUND

Cancer survivors develop other chronic medical conditions because of shared risk factors and delayed effects of cancer treatment. This study investigated trends in the prevalence of chronic diseases and estimated their population sizes among adult cancer survivors in the United States from 2002 to 2018.

METHODS

Using 2002-2018 National Health Interview Survey data, this study calculated the age-sex-race/ethnicity-adjusted prevalences and estimated the population sizes for the following chronic conditions among cancer survivors: hypertension, diabetes, stroke, heart disease, chronic obstructive pulmonary disease (COPD)/asthma, hepatitis, arthritis, liver disease, kidney disease, and morbid obesity. This study also examined multiple chronic conditions (MCC; 3 or more health conditions). MCC trends were further examined by sociodemographic factors to identify high-risk populations. Parallel analyses were performed for participants without a cancer history to provide a reference.

RESULTS

Among 30,728 cancers survivors, increasing trends were observed in the prevalence of hypertension, diabetes, kidney disease, liver disease, and morbid obesity, whereas decreasing prevalence trends were observed for ischemic heart disease, COPD, and hepatitis. Cancer survivors with MCC increased from 4.7 million in 2002 to 8.1 million in 2018 (the prevalence increased from 43.7% to 46.6%). The increase was more pronounced among survivors aged 18 to 44 years. Among adults without a cancer history, the MCC prevalence also increased, although more slowly than among survivors.

CONCLUSIONS

The number of adult cancer survivors in the United States with comorbid illnesses has increased substantially over the past 2 decades. Optimal management of comorbid conditions and aggressive interventions for risk reduction may benefit the cancer survivor population.

摘要

背景

由于共同的风险因素和癌症治疗的延迟效应,癌症幸存者会发展出其他慢性疾病。本研究调查了美国成年癌症幸存者中慢性疾病的流行趋势,并估计了 2002 年至 2018 年期间这些疾病的人群规模。

方法

本研究使用 2002-2018 年全国健康访谈调查数据,计算了癌症幸存者中以下慢性疾病的年龄性别种族/族裔调整患病率,并估计了这些疾病的人群规模:高血压、糖尿病、中风、心脏病、慢性阻塞性肺疾病(COPD)/哮喘、肝炎、关节炎、肝病、肾病和病态肥胖。本研究还检查了多种慢性疾病(MCC;3 种或更多健康状况)。通过社会人口统计学因素进一步检查了 MCC 趋势,以确定高危人群。对没有癌症病史的参与者进行了平行分析,以提供参考。

结果

在 30728 名癌症幸存者中,高血压、糖尿病、肾病、肝病和病态肥胖的患病率呈上升趋势,而缺血性心脏病、COPD 和肝炎的患病率呈下降趋势。患有 MCC 的癌症幸存者从 2002 年的 470 万增加到 2018 年的 810 万(患病率从 43.7%增加到 46.6%)。在 18 至 44 岁的幸存者中,这种增长更为明显。在没有癌症病史的成年人中,MCC 的患病率也有所增加,尽管增长速度比幸存者慢。

结论

在过去的 20 年里,美国患有合并症的癌症幸存者人数大幅增加。对合并症的最佳管理和积极的风险降低干预措施可能有益于癌症幸存者群体。

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