Abstract
Background: Pre-existing chronic conditions (morbidities) influence the diagnosis and management of cancer. The prevalence of specific morbidities in patients diagnosed with common and rarer cancers is inadequately described. Methods: Using data from the English National Cancer Diagnosis Audit 2014, we studied 11 pre-existing morbidities recorded as yes/no items by participating general practitioners based on information included in primary care records. We examined the number and type of morbidities across socio-demographic and cancer site strata, and subsequently estimated observed and age/sex standardised prevalence of each morbidity by cancer. Results: Over three-quarters (77 %; 11,429/14,774) of non-screen-detected patients had at least one chronic condition before diagnosis, while nearly half (47 %) had two or more. Hypertension (39 %) and physical disability (2%) were the most and least common conditions. Male, older and more socio-economically deprived patients were more likely to have at least one morbidity (p < 0.001 for all between variable group comparisons). For most morbidities, the standardised prevalence was similar across different cancers with a few exceptions, including respiratory disease prevalence being greatest among lung cancer patients and diabetes prevalence being greatest among liver, pancreatic, and endometrial cancer patients. Conclusions: Most cancer patients have at least one morbidity, while almost one in two have two or more. The findings highlight the need to take certain morbidity- and cancer-site combinations into account when examining associations between morbidity and cancer outcomes.
| Original language | English |
|---|---|
| Article number | 101845 |
| Journal | Cancer Epidemiology |
| Volume | 69 |
| DOIs | |
| Publication status | Published - Dec 2020 |
Bibliographical note
Funding Information:The authors would like to thank all GPs and health professionals who participated in the NCDA, and contributing Cancer Research UK staff; the National Cancer Registration and Analysis Service, NHS England, the Royal College of General Practitioners, Macmillan Cancer Support, and Health Data Insight. This work uses data that has been provided by patients and collected by the NHS as part of their care and support. The data is collated, maintained and quality assured by the National Cancer Registration and Analysis Service, which is part of Public Health England (PHE). The NCDA received enabling support from Cancer Research UK, NHS England, and the National Cancer Registration and Analysis Service. This research arises from the CanTest Collaborative, which is funded by Cancer Research UK [C8640/A23385], of which GPR is Chair, GL Associate Director, GAA Co-investigator, CR Clinical Research Fellow, and MMK Postdoctoral Fellow. GL is supported by Cancer Research UK Clinician Advanced Scientist Fellowship [grant number: C18081/A18180]. The views expressed are those of the authors and not necessarily those of Cancer Research UK.
Funding Information:
The NCDA received enabling support from Cancer Research UK, NHS England, and the N ational Cancer Registration and Analysis Service. This research arises from the CanTest Collaborative, which is funded by Cancer Research UK [ C8640/A23385 ], of which GPR is Chair, GL Associate Director, GAA Co-investigator, CR Clinical Research Fellow, and MMK Postdoctoral Fellow. GL is supported by Cancer Research UK Clinician Advanced Scientist Fellowship [grant number: C18081/A18180] . The views expressed are those of the authors and not necessarily those of Cancer Research UK .
Publisher Copyright:
© 2020 The Author(s)
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
Keywords
- Cancer outcomes
- Comorbidities
- Epidemiology
- Long-term conditions
- Oncology
