Impact of Undetected Comorbidity on Treatment and Outcomes of Breast Cancer
Joint Authors
Danese, Mark D.
Gleeson, Michelle L.
Valderas, José M.
Griffiths, Robert I.
Source
International Journal of Breast Cancer
Issue
Vol. 2014, Issue 2014 (31 Dec. 2014), pp.1-11, 11 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2014-02-13
Country of Publication
Egypt
No. of Pages
11
Main Subjects
Abstract EN
Preexisting comorbidity adversely impacts breast cancer treatment and outcomes.
We examined the incremental impact of comorbidity undetected until cancer.
We followed breast cancer patients in SEER-Medicare from 12 months before to 84 months after diagnosis.
Two comorbidity indices were constructed: the National Cancer Institute index, using 12 months of claims before cancer, and a second index for previously undetected conditions, using three months after cancer.
Conditions present in the first were excluded from the second.
Overall, 6,184 (10.1%) had ≥1 undetected comorbidity.
Chronic obstructive pulmonary disease (38%) was the most common undetected condition.
In multivariable analyses that adjusted for comorbidity detected before cancer, older age, later stage, higher grade, and poor performance status all were associated with higher odds of ≥1 undetected comorbidity.
In stage I–III cancer, undetected comorbidity was associated with lower adjusted odds of receiving adjuvant chemotherapy (Odds Ratio (OR) = 0.81, 95% Confidence Interval (CI) 0.73–0.90, P<0.0001; OR=0.38, 95% CI 0.30–0.49, P<0.0001; index score 1 or ≥2, respectively), and with increased mortality (Hazard Ratio (HR) = 1.45, 95% CI 1.38–1.53, P<0.0001; HR=2.38, 95% CI 2.18–2.60, P<0.0001; index score 1 or ≥2).
Undetected comorbidity is associated with less aggressive treatment and higher mortality in breast cancer.
American Psychological Association (APA)
Griffiths, Robert I.& Gleeson, Michelle L.& Valderas, José M.& Danese, Mark D.. 2014. Impact of Undetected Comorbidity on Treatment and Outcomes of Breast Cancer. International Journal of Breast Cancer،Vol. 2014, no. 2014, pp.1-11.
https://search.emarefa.net/detail/BIM-512389
Modern Language Association (MLA)
Griffiths, Robert I.…[et al.]. Impact of Undetected Comorbidity on Treatment and Outcomes of Breast Cancer. International Journal of Breast Cancer No. 2014 (2014), pp.1-11.
https://search.emarefa.net/detail/BIM-512389
American Medical Association (AMA)
Griffiths, Robert I.& Gleeson, Michelle L.& Valderas, José M.& Danese, Mark D.. Impact of Undetected Comorbidity on Treatment and Outcomes of Breast Cancer. International Journal of Breast Cancer. 2014. Vol. 2014, no. 2014, pp.1-11.
https://search.emarefa.net/detail/BIM-512389
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-512389