Similarities and differences in the correlates of comorbidities in US male and female adult cancer survivors

Abstract

Objectives To determine both the common and the sex‐specific correlates of comorbidities in adult male and female cancer survivors. Design Cross‐sectional study using the 2009–2014 National Health and Nutrition Examination Survey (NHANES). Sample Male (n = 667) and female (n = 772) cancer survivors 20 years of age and older. Measurements Questionnaire responses from NHANES provided data for this study. Comorbidities were assessed using a modified Charlson Comorbidity Index (CCI). Bivariate and multivariate linear regression analyses were conducted to identify correlates of comorbidities in male and female cancer survivors separately. Results The mean modified CCI score was 3.88 in males and 3.68 in females. Having a greater number of cancers diagnosed, being currently or formerly married, being physically inactive, having lower socioeconomic status, and being a former smoker were significant correlates of comorbidities in both males and females. Having a prostate cancer diagnosis was also a significant correlate of comorbidities in males. White race, more years since first cancer diagnosis, being overweight or obese, and having no more than a high school education were also significant correlates of comorbidities in females. Conclusions There are differences between correlates of comorbidities in male and female cancer survivors.

Multimorbidity and Employment Outcomes Among Middle-Aged US Cancer Survivors

“…We observed significant socioeconomic differences between the three multimorbidity groups, as cancer survivors in the high multimorbidity group tended to have lower levels of household income and education than survivors in the other two multimorbidity groups. These associations between indicators of low socioeconomic status and multimorbidity are consistent with the findings from previous studies of cancer and non-cancer patient populations 5,34–36 . However, while gender differences in multimorbidity have been reported in the non-cancer populations, 37,38 we did not observe any gender differences across the three multimorbidity groups.…”

“…These associations between indicators of low socioeconomic status and multimorbidity are consistent with the findings from previous studies of cancer and non-cancer patient populations. 5,[34][35][36] However, while gender differences in multimorbidity have been reported in the non-cancer populations, 37,38 we did not observe any gender differences across the three multimorbidity groups. Also, there were no significant differences with respect to age or the proportion of long-term survivors (5 þ years since diagnosis), indicating that our multimorbidity profiles were not dependent on the length of cancer survivorship.…”

“…Our observation that the significant associations between high and moderate psychiatric multimorbidity profiles and prolonged unemployment were found only among low income (less than 138% of federal poverty level) cancer survivors is especially important, given the well-documented adverse financial impacts of cancer care and the fact that low-income survivors are more likely to report co-occurring chronic conditions than their wealthier counterparts. 5,35,36 All together, these findings may have implications for mitigating the adverse effects of multimorbidity in middle-aged cancer survivors, as interventions to treat and manage co-occurring psychiatric conditions may confer significant economic benefits, particularly among lower income survivors.…”