@misc{10481/71006,
year = {2021},
month = {9},
url = {http://hdl.handle.net/10481/71006},
abstract = {Aim: Chronic diseases often occur simultaneously and tend to be associated with adverse health outcomes, but
limited research has been undertaken to understand their role in lung cancer mortality. Therefore, this study aims
to describe the prevalence and patterns of having one (comorbidity) or ≥ 2 chronic diseases (multimorbidity)
among lung cancer patients in Spain, and to examine the association between comorbidity or multimorbidity and
short-term mortality risk at six months after cancer diagnosis.
Methods: In this population-based cohort study, data were drawn from two Spanish population-based cancer
registries, Girona and Granada, and electronic health records. We identified 1259 adult lung cancer patients,
diagnosed from 1st January 2011 to 31st December 2012. We identified the most common patterns of individual
comorbidities and their pairwise correlations. We used a flexible parametric modelling approach to assess the
overall short-term mortality risk 6 months after cancer diagnosis by levels of comorbidity after adjusting for age, sex,
smoking status, province of residence, surgery, cancer stage, histology, and body mass index.
Results: We found high prevalence of comorbidity in lung cancer patients, especially among the elderly, men,
those diagnosed with advanced-stage tumours, smokers, and obese patients. The most frequent comorbidities
were chronic obstructive pulmonary disease (36.6%), diabetes (20.7%) and heart failure (16.8%). The strongest
pairwise correlation was the combination of heart failure with renal disease (r = 0.20, p < 0.01), and heart failure with
diabetes (r = 0.16, p < 0.01). Patients with either one or two or more comorbidities had 40% higher overall mortality
risk than those without comorbidities (aHR for comorbidity: 1.4, 95%CI: 1.1–1.7; aHR for multimorbidity: 1.4, 95%CI:
1.1–1.8), when relevant confounding factors were considered. Conclusions: The presence of comorbid diseases, rather than the number of comorbidities, was associated with
increasing the risk of short-term lung cancer mortality in Spain. Comorbidity was a consistent and independent
predictor of mortality among lung cancer patients, six months after diagnosis. The most common comorbid
conditions were age-, obesity- and tobacco-related diseases. Our findings highlight the need to develop targeted
preventive interventions and more personalised clinical guidelines to address the needs of lung cancer patients
with one or more comorbidities in Spain.},
organization = {Instituto de Salud Carlos III	CP17/00206-EU-FEDER	
EU-FEDER-FIS PI-18/01593},
organization = {Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiologia y Salud Publica)},
organization = {Cancer Epidemiological Surveillance Subprogram (VICA) from the Instituto de Salud Carlos III, Madrid, Spain},
organization = {Andalusian Department of Health	PI-0152/2017},
publisher = {BMC},
keywords = {Lung Neoplasms},
keywords = {Comorbidity},
keywords = {Multimorbidity},
keywords = {Mortality},
keywords = {Cancer epidemiology},
title = {The role of multimorbidity in short-term mortality of lung cancer patients in Spain: a population-based cohort study},
doi = {10.1186/s12885-021-08801-9},
author = {Niksic, Maja and Redondo Sánchez, Daniel and Chang, Yoe-Ling and Rodríguez Barranco, Miguel and Expósito Hernández, José and Sánchez Pérez, María José and Luque Fernández, Miguel Ángel},
}