Division of Cancer Sciences, The University of Manchester, Manchester, United Kingdom.
The Christie NHS Foundation Trust, Manchester, United Kingdom.
Br J Cancer. 2024 Nov;131(8):1279-1289. doi: 10.1038/s41416-024-02838-w. Epub 2024 Sep 4.
Comorbidities have been shown to impact the presentation and treatment of patients with cancers. This study investigates the prevalence and patterns of comorbidity in a pan-cancer cohort of patients treated at a large UK specialist cancer center over a 9-year period.
A retrospective review of 77,149 patients from 01/01/2014 to 15/12/2022 was conducted using the Adult Comorbidity Evaluation 27 score (ACE-27) to assess the burden of comorbidities across 12 organ systems and an overall comorbidity burden. Binary and multinomial logistic regressions were utilized to evaluate the relationships between comorbidity incidence and demographic and socio-economic factors.
At the time of diagnosis, 59.7% of patients had at least one comorbidity, with the highest prevalence in lung cancer and the lowest in brain/CNS and endocrine gland cancers. Cardiovascular comorbidities were the most frequent. Comorbidity severity was higher in patients from more deprived areas. Age and performance status were associated with a higher incidence of all comorbidities examined. Patients with advanced stage had a lower risk of having a severe comorbidity burden.
Comorbidities are common across all cancers but are more prevalent in certain patient populations. Further research to understand the implications of comorbidities in cancer management is needed.
合并症已被证明会影响癌症患者的表现和治疗。本研究调查了在英国一家大型癌症专科中心治疗的泛癌症患者队列中 9 年来合并症的患病率和模式。
使用成人合并症评估 27 分(ACE-27)对 2014 年 1 月 1 日至 2022 年 12 月 15 日的 77,149 名患者进行回顾性审查,以评估 12 个器官系统和整体合并症负担的合并症负担。采用二项式和多项逻辑回归评估合并症发生率与人口统计学和社会经济因素之间的关系。
在诊断时,59.7%的患者至少有一种合并症,肺癌的患病率最高,脑/中枢神经系统和内分泌腺癌的患病率最低。心血管合并症最为常见。来自较贫困地区的患者合并症严重程度更高。年龄和表现状态与所有检查的合并症发生率较高相关。晚期患者发生严重合并症负担的风险较低。
合并症在所有癌症中都很常见,但在某些患者人群中更为普遍。需要进一步研究来了解合并症对癌症管理的影响。