The pattern of comorbidities in cancer patients in Lagos, South-Western Nigeria

Abstract

PurposeComorbidities have been indicated to influence cancer care and outcome, with strong associations between the presence of comorbidities and patient survival. The objective of this study is to determine the magnitude and pattern of comorbidities in Nigerian cancer populations, and demonstrate the use of comorbidity indices in predicting mortality/survival rates of cancer patients.MethodsUsing a retrospective study design, data were extracted from hospital reports of patients presenting for oncology care between January 2015 and December 2016 at two tertiary health facilities in Lagos, Nigeria. Patient comorbidities were ranked and weighted using the Charlson comorbidity index (CCI).ResultsThe mean age for the 848 cancer patients identified was 53.9 ± 13.6 years, with 657 (77.5%) females and 191 (22.5%) males. Breast (50.1%), cervical (11.1%) and colorectal (6.3%) cancers occurred most frequently. Comorbidities were present in 228 (26.9%) patients, with the most common being hypertension (20.4%), diabetes (6.7%) and peptic ulcer disease (2.1%). Hypertension-augmented CCI scores were 0 (15.6%), 1–3 (62.1%), 4–6 (21.7%) and ≥7 (0.6%). The mean CCI scores of patients ≤50 years (0.8 ± 0.9) and ≥51 years (3.3 ± 1.2) were significantly different (p < 0.05). Patients with lower mean CCI scores were more likely to receive chemotherapy (2.2 ± 1.6 versus 2.5 ± 1.9; p < 0.05) and/or surgery (2.1 ± 1.5 versus 2.4 ± 1.7; p < 0.05).ConclusionComorbidities occur significantly in Nigerian cancer patients and influence the prognosis, treatment outcome and survival rates of these patients. There is a need to routinely evaluate cancer patients for comorbidities with the aim of instituting appropriate multidisciplinary management measures where necessary.

Major depressive disorders in outpatients with cancers at the Nigerian National Hospital

“…The similarity of these findings could be as result of the resemblance in the cosmopolitan characteristics of the participants and other psychosocial difficulties of living with cancer in the country. As noted earlier, many peculiar factors come to play from the early period of cancer inception, during treatment to recovery in Nigeria 10–15 . Moreover, biological studies revealed that immunological activities to fight off cancer cells have been implicated in the evolution of depressive disorders in the population of patients with cancers 8,9 .…”

“…During treatment, the financial burden and poor compliance with medications are possible interfering factors 12,13 . Frequently, there are associated co‐morbidities of other medical conditions such as diabetes mellitus, hypertension and peptic ulcer disease, 14 and dealing with these other conditions at the same time can be challenging to the patient and the health facilities. Moreover, people travel long distances in other to access quality cancer treatment because of few treatment centres in the country 15 .…”

It’s contrary – comorbidity does not affect survival of South Africans with colorectal cancer: An analysis from the Colorectal Cancer in South Africa cohort

“…When compared with HICs, a possible explanation for the lower prevalence of comorbid disease in our study and other studies from SSA may be the younger mean ages at presentation (53 -56 years). [27][28][29][30][31][32][33] Aside from SSA, younger mean ages (45 -67 years) have been observed in South Asia, China and Brazil. [34,35] Collectively, these findings from LMICs contrast with those from HICs, where median ages are ~10 -15 years older, and comorbidity is twice as high and adversely affects…”

Coexisting Conditions among Children and Adolescents with Cancer in a Section of the South African Private Health Sector: Perspectives from Drug Utilization Data

“…The prevalence of conditions coexisting in adults with cancer, especially chronic conditions such as hypertension, diabetes, peptic ulcer, and other cardiovascular conditions has been described in literature [ 15 – 18 ]. There is, however, a paucity of information on the prevalence of coexisting conditions in children with cancer in South Africa.…”

“…There is, however, a paucity of information on the prevalence of coexisting conditions in children with cancer in South Africa. Cognizance of coexisting conditions in patients with cancer is important due to their possible influence on treatment decisions—by the modification of treatment protocols—and the consequent impact on treatment outcome [ 1 , 15 , 19 – 21 ]. This study, therefore, aimed at identifying conditions that coexist with cancer in children and adolescents undergoing cancer chemotherapy in the South African private health sector.…”