University of South Australia Allied Health and Human Performance, South Australia, Adelaide, Australia.
Cancer epidemiology and population health, University of South Australia, South Australia, Adelaide, Australia.
Cancer Med. 2023 Jun;12(11):12118-12127. doi: 10.1002/cam4.5901. Epub 2023 Apr 21.
Advanced age is associated with decreased likelihood of colorectal cancer treatment. Here, we investigated the extent to which comorbidities are accountable for this lesser treatment.
Using population-based datasets, the pattern of care among CRC cases in South Australia during 2004-2013 was investigated. Models were used to investigate associations of age with each treatment type, and differences in these associations were explored by comorbidity and cancer site.
The presence of comorbidity was associated with a significantly weaker relationship of age with surgery and chemotherapy. The association of age with surgery also varied for colon and rectal primary cancer sites. Individual comorbidity types varied in their associations with each treatment category. For example, dementia was associated with less chemotherapy provision, however, it was not significantly related to the likelihood of surgery.
This study indicates that the association of age with surgical treatment differed significantly by the CRC subsite. Comorbidity moderated the negative association of age with chemotherapy, and less so, with extent of surgery. Results were novel in indicating associations of multiple individual comorbidity types with CRC treatment modalities. The data suggest that different individual comorbidity types may have different effects on treatment and should be studied separately.
高龄与结直肠癌治疗的可能性降低有关。在这里，我们研究了合并症在多大程度上解释了这种治疗减少的原因。
利用基于人群的数据集，调查了 2004 年至 2013 年期间南澳大利亚州结直肠癌病例的治疗模式。使用模型来研究年龄与每种治疗类型的关联，并通过合并症和癌症部位来探讨这些关联的差异。
合并症的存在与手术和化疗与年龄的关系明显减弱有关。年龄与手术的关联也因结肠和直肠原发性癌症部位的不同而有所不同。单独的合并症类型在与每种治疗类别相关方面存在差异。例如，痴呆与化疗提供的可能性较低有关，但与手术的可能性没有显著相关。
本研究表明，年龄与手术治疗的关联因结直肠癌亚部位的不同而有显著差异。合并症调节了年龄与化疗的负相关，对手术范围的影响较小。结果表明，多种单独的合并症类型与结直肠癌的治疗方式存在关联，这是新颖的。数据表明，不同的单独合并症类型可能对治疗有不同的影响，应分别进行研究。
