Comorbidity and survival of Danish patients with colon and rectal cancer from 2000–2011: a population-based cohort study

Abstract

ObjectiveTo evaluate recent trends in the prevalence and impact of comorbidity on colorectal cancer (CRC) survival in the Central Region of Denmark.Material and methodsUsing the Danish National Registry of Patients, we identified 5,777 and 2,964 patients with a primary colon or rectal cancer, respectively, from 2000 through 2011. We estimated survival according to Charlson Comorbidity Index scores and computed mortality rate ratios (MRRs) using Cox proportional hazard regression analysis, adjusting for age and sex.ResultsMore than one-third of CRC patients had comorbidity at diagnosis. During the study period, 1-year survival increased substantially in colon cancer patients with Charlson score 0 (72% to 80%) and modestly for Charlson score 3+ patients (43% to 46%). Using colon cancer patients with Charlson score 0 as reference, adjusted 1-year MRRs in patients with Charlson score 3+ were 2.19 (95% confidence interval [CI]: 1.57–3.05) in 2000–2002 and 2.56 (95% CI: 1.96–3.35) in 2009–2011. One-year survival after rectal cancer improved from 81% to 87% in patients with Charlson score 0 and from 56% to 60% in Charlson score 3+. Corresponding MRRs in patients with Charlson 3+ were 2.21 (95% CI: 1.33–3.68) in 2000–2002 and 3.09 (95% CI: 1.91–5.00) in 2009–2011 using Charlson score 0 as reference. Five-year MRRs did not differ substantially from 1-year MRRs.ConclusionComorbidity was common among CRC patients and was associated with poorer prognosis. We observed improved survival from 2000 to 2011 for all comorbidity levels, with least improvement for colon cancer patients with comorbid conditions.

Comorbidities and its relation to performance status and estimated survival rate among cancer patients

“…Colorectal cancer had significantly more comorbidities, which was osteoporosis and combination of diabetes and ischemic heart disease. This reduces the performance score of the patients and these results correlate with the results of other reports [13]. Studies confirm that colorectal cancer is mostly caused by lifestyle factors such as less healthy diet, obesity, and poor physical activity as well as conditions like DM and vascular diseases [14].…”

Local ablation or radioembolization of colorectal cancer metastases: comorbidities or older age do not affect overall survival

“…In our group of metastatic CRC patients, about 62% had comorbidities according to the CCI. Adding conditions as hypertension, hyperlipidemia and obesity, 71% of patients were suffering from comorbidities, which is far more frequent than in other studies applying the CCI reporting a prevalence between 32 and 41% in metastatic or non-metastatic CRC patients [ 31 ].…”

One-Year Mortality in Older Patients with Cancer: Development and External Validation of an MNA-Based Prognostic Score

“…The influence of comorbidities, although considered as important in the frailty assessment, was not directly evaluated but can be approximated by using the number of prescribed drugs, which is a parameter that is very easy to obtain. Severe comorbidities according to the Charlson index have been found to be poor prognostic factors in colon cancer [ 36 ]. The mechanisms of this effect seem unclear since the causes of death were mainly the cancer itself.…”