Noone Anne-Michelle, Mariotto Angela B, Hong Yoon Duk, Enewold Lindsey
Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland.
Cancer Epidemiol Biomarkers Prev. 2025 Jan 9;34(1):182-189. doi: 10.1158/1055-9965.EPI-24-0833.
Almost half of Medicare beneficiaries diagnosed with cancer from 1992 to 2005 had at least one comorbid condition. Conditions affect a range of domains from clinical decision-making to quality of life, which are important to consider when conducting cancer research. We introduce a new Surveillance, Epidemiology, and End Results (SEER)-Medicare resource to facilitate using claims data for patients with cancer.
We use the SEER-Medicare resource to estimate prevalence of comorbidities, 5-year survival rate by cancer site, stage, age and comorbidity severity, and prevalence of surgery by comorbidity for breast, prostate, colorectal and lung cancers.
Overall, the most prevalent comorbidities in the year prior to cancer diagnosis were diabetes (27%), chronic obstructive pulmonary disease (22%), peripheral vascular disease (14%), and congestive heart failure (12%). Comorbidity severity had a greater impact on the probability of dying from noncancer causes than dying from cancer. Severity of comorbidity and age consistently increased the probability of noncancer death. The percentage of persons receiving surgery tended to be lower among those with severe comorbidity.
This study demonstrates the utility of new SEER*Stat databases that contain Medicare beneficiaries and claims-based measures of comorbidity. Our results demonstrate that comorbidity is common among older persons diagnosed with cancer and the impact of comorbidity on the probability of dying from cancer varies by cancer site, stage at diagnosis, and age.
Comorbidity is common among persons with cancer and affects survival. Future research on the impact of comorbidity among cancer survivors is facilitated by new databases.
1992年至2005年期间，近一半被诊断患有癌症的医疗保险受益人至少有一种合并症。这些合并症影响从临床决策到生活质量等一系列领域，在开展癌症研究时需要予以考虑。我们引入了一种新的监测、流行病学和最终结果（SEER）-医疗保险资源，以促进利用癌症患者的理赔数据。
我们使用SEER-医疗保险资源来估计合并症的患病率、按癌症部位、分期、年龄和合并症严重程度划分的5年生存率，以及乳腺癌、前列腺癌、结直肠癌和肺癌按合并症划分的手术患病率。
总体而言，在癌症诊断前一年最常见的合并症为糖尿病（27%）、慢性阻塞性肺疾病（22%）、外周血管疾病（14%）和充血性心力衰竭（12%）。合并症严重程度对因非癌症原因死亡的概率影响大于因癌症死亡的概率。合并症严重程度和年龄持续增加非癌症死亡的概率。合并症严重的患者接受手术的比例往往较低。
本研究证明了包含医疗保险受益人和基于理赔的合并症测量指标的新SEER*Stat数据库的实用性。我们的结果表明，合并症在被诊断患有癌症的老年人中很常见，并且合并症对因癌症死亡概率的影响因癌症部位、诊断时的分期和年龄而异。
合并症在癌症患者中很常见且影响生存。新数据库有助于未来对癌症幸存者中合并症影响的研究。
