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Comorbidities linked to worse lung cancer survival


Lung cancer patients with comorbid conditions such as chronic obstructive pulmonary disease ( COPD ), diabetes mellitus, or congestive heart failure had a higher risk of death than lung cancer patients without comorbid conditions, according to a study published in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research.

The prevalence of comorbidities is higher in older lung cancer patients than patients who are younger.

Lung cancer is the leading cause of cancer death in the United States, killing more than 135,000 people per year. More people die from lung cancer annually than die from breast, colon, and prostate cancers combined.
The five-year survival rate is only about 17%.

Currently, survival is the only significant measure of treatment success. Comorbid conditions can affect lung cancer survival in many ways, including complicating diagnostic evaluation, leading to less accurate disease staging.

Researchers at University of Nebraska Medical Center College of Public Health found that lung cancer patients with comorbidities had about a nine-month average survival, which is shorter than the national average.
They also found that 74% of the patients had one or more comorbidities. More than 50% of those with comorbidities had pulmonary disease, while 16% had diabetes mellitus, and 13% had congestive heart failure.

Researchers found that among patients with localized lung cancer, those with one comorbidity had a 30% higher risk of mortality compared with those who had no comorbidity. Among patients with metastatic lung cancer, comorbidity had less impact on survival.

Patients with comorbidity were found to have poorer survival at each stage, he said, and the difference in survival between patients with and without comorbidity seemed to be greater in less advanced stages.

To analyze the overall survival of lung cancer patients with or without comorbidities, research team conducted a population-based cohort study of 5,683 lung cancer patients identified from the Nebraska Cancer Registry and Nebraska Hospital Discharge Data. They also studied the overall survival in patients with any of the 14 comorbidities identified from the Charlson Comorbidity Index.

The results are based on cancer registry data from one state, so the results may not be generalizable to other populations. There is a need for a prospective study to confirm these results. ( Xagena )

Source: American Association for Cancer Research ( AACR ), 2015

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