Effects of cancer history and comorbid conditions on mortality and healthcare use among older cancer survivors

Pearl H Seo, Carl F. Pieper, Harvey Jay Cohen

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

BACKGROUND. Older cancer survivors use healthcare services to an increased extent relative to their counterparts who have no history of malignant disease. In the current study, the authors set out to assess the effects of cancer history and comorbid conditions on healthcare use and mortality. METHODS. Using information from the 1992 North Carolina Established Populations for Epidemiologic Study of the Elderly database, study participants were classified as having no history of malignant disease or as having a recent (cancer diagnosed < 1 year earlier), intermediate (cancer diagnosed 1-6 years earlier), or remote (cancer diagnosed > 6 years earlier) history of malignancy. Overall, 15 different comorbid conditions were ascertained. Logistic regression models adjusted for sociodemographic factors, tobacco and alcohol use, and functional measures were used to determine the risk of emergency room, hospital, and nursing home (NH) admission in 1992 and also in 1996 according to history of malignancy and presence of comorbid conditions. Using data from the National Death Registry, a similar controlled analysis of 7-year mortality also was performed. RESULTS. There were 2567 participants in the current study (mean age, 79 years; range, 71-102 years); 69% of all participants were women, 55% were African American, and 14% reported having a history of malignancy. Participants with a history of malignancy had an average of 3 comorbid conditions, and differences across groups in terms of cardiovascular and lung disease incidence were noted. Controlled analyses revealed that recent cancer history (odds ratio [OR], 15.5; 95% confidence interval [CI], 7.0-34.2) and intermediate cancer history (OR, 2.1; 95% CI, 1.4-3.3) were associated with same-year hospital admission. In addition, having a recent history of malignancy in 1992 was found to be correlated with NH admission 4 years later (OR, 3.1; 95% CI, 1.1-9.1). History of malignancy was not associated with mortality. CONCLUSIONS. Cancer history had limited influence on healthcare use and mortality. Efforts aimed at improving health-related outcomes in older cancer survivors should continue to focus on attenuating the impact of comorbid conditions.

Original languageEnglish
Pages (from-to)2276-2284
Number of pages9
JournalCancer
Volume101
Issue number10
DOIs
StatePublished - Nov 15 2004
Externally publishedYes

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Survivors
Delivery of Health Care
Mortality
Neoplasms
Odds Ratio
Confidence Intervals
Nursing Homes
Logistic Models
Emergency Nursing
Tobacco Use
African Americans
Lung Diseases
Registries
Epidemiologic Studies
Cardiovascular Diseases
Alcohols
Databases

Keywords

  • Aged
  • Cancer survivorship
  • Comorbidity
  • Healthcare use
  • Mortality

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Effects of cancer history and comorbid conditions on mortality and healthcare use among older cancer survivors. / Seo, Pearl H; Pieper, Carl F.; Cohen, Harvey Jay.

In: Cancer, Vol. 101, No. 10, 15.11.2004, p. 2276-2284.

Research output: Contribution to journalArticle

Seo, Pearl H ; Pieper, Carl F. ; Cohen, Harvey Jay. / Effects of cancer history and comorbid conditions on mortality and healthcare use among older cancer survivors. In: Cancer. 2004 ; Vol. 101, No. 10. pp. 2276-2284.
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title = "Effects of cancer history and comorbid conditions on mortality and healthcare use among older cancer survivors",
abstract = "BACKGROUND. Older cancer survivors use healthcare services to an increased extent relative to their counterparts who have no history of malignant disease. In the current study, the authors set out to assess the effects of cancer history and comorbid conditions on healthcare use and mortality. METHODS. Using information from the 1992 North Carolina Established Populations for Epidemiologic Study of the Elderly database, study participants were classified as having no history of malignant disease or as having a recent (cancer diagnosed < 1 year earlier), intermediate (cancer diagnosed 1-6 years earlier), or remote (cancer diagnosed > 6 years earlier) history of malignancy. Overall, 15 different comorbid conditions were ascertained. Logistic regression models adjusted for sociodemographic factors, tobacco and alcohol use, and functional measures were used to determine the risk of emergency room, hospital, and nursing home (NH) admission in 1992 and also in 1996 according to history of malignancy and presence of comorbid conditions. Using data from the National Death Registry, a similar controlled analysis of 7-year mortality also was performed. RESULTS. There were 2567 participants in the current study (mean age, 79 years; range, 71-102 years); 69{\%} of all participants were women, 55{\%} were African American, and 14{\%} reported having a history of malignancy. Participants with a history of malignancy had an average of 3 comorbid conditions, and differences across groups in terms of cardiovascular and lung disease incidence were noted. Controlled analyses revealed that recent cancer history (odds ratio [OR], 15.5; 95{\%} confidence interval [CI], 7.0-34.2) and intermediate cancer history (OR, 2.1; 95{\%} CI, 1.4-3.3) were associated with same-year hospital admission. In addition, having a recent history of malignancy in 1992 was found to be correlated with NH admission 4 years later (OR, 3.1; 95{\%} CI, 1.1-9.1). History of malignancy was not associated with mortality. CONCLUSIONS. Cancer history had limited influence on healthcare use and mortality. Efforts aimed at improving health-related outcomes in older cancer survivors should continue to focus on attenuating the impact of comorbid conditions.",
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T1 - Effects of cancer history and comorbid conditions on mortality and healthcare use among older cancer survivors

AU - Seo, Pearl H

AU - Pieper, Carl F.

AU - Cohen, Harvey Jay

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Y1 - 2004/11/15

N2 - BACKGROUND. Older cancer survivors use healthcare services to an increased extent relative to their counterparts who have no history of malignant disease. In the current study, the authors set out to assess the effects of cancer history and comorbid conditions on healthcare use and mortality. METHODS. Using information from the 1992 North Carolina Established Populations for Epidemiologic Study of the Elderly database, study participants were classified as having no history of malignant disease or as having a recent (cancer diagnosed < 1 year earlier), intermediate (cancer diagnosed 1-6 years earlier), or remote (cancer diagnosed > 6 years earlier) history of malignancy. Overall, 15 different comorbid conditions were ascertained. Logistic regression models adjusted for sociodemographic factors, tobacco and alcohol use, and functional measures were used to determine the risk of emergency room, hospital, and nursing home (NH) admission in 1992 and also in 1996 according to history of malignancy and presence of comorbid conditions. Using data from the National Death Registry, a similar controlled analysis of 7-year mortality also was performed. RESULTS. There were 2567 participants in the current study (mean age, 79 years; range, 71-102 years); 69% of all participants were women, 55% were African American, and 14% reported having a history of malignancy. Participants with a history of malignancy had an average of 3 comorbid conditions, and differences across groups in terms of cardiovascular and lung disease incidence were noted. Controlled analyses revealed that recent cancer history (odds ratio [OR], 15.5; 95% confidence interval [CI], 7.0-34.2) and intermediate cancer history (OR, 2.1; 95% CI, 1.4-3.3) were associated with same-year hospital admission. In addition, having a recent history of malignancy in 1992 was found to be correlated with NH admission 4 years later (OR, 3.1; 95% CI, 1.1-9.1). History of malignancy was not associated with mortality. CONCLUSIONS. Cancer history had limited influence on healthcare use and mortality. Efforts aimed at improving health-related outcomes in older cancer survivors should continue to focus on attenuating the impact of comorbid conditions.

AB - BACKGROUND. Older cancer survivors use healthcare services to an increased extent relative to their counterparts who have no history of malignant disease. In the current study, the authors set out to assess the effects of cancer history and comorbid conditions on healthcare use and mortality. METHODS. Using information from the 1992 North Carolina Established Populations for Epidemiologic Study of the Elderly database, study participants were classified as having no history of malignant disease or as having a recent (cancer diagnosed < 1 year earlier), intermediate (cancer diagnosed 1-6 years earlier), or remote (cancer diagnosed > 6 years earlier) history of malignancy. Overall, 15 different comorbid conditions were ascertained. Logistic regression models adjusted for sociodemographic factors, tobacco and alcohol use, and functional measures were used to determine the risk of emergency room, hospital, and nursing home (NH) admission in 1992 and also in 1996 according to history of malignancy and presence of comorbid conditions. Using data from the National Death Registry, a similar controlled analysis of 7-year mortality also was performed. RESULTS. There were 2567 participants in the current study (mean age, 79 years; range, 71-102 years); 69% of all participants were women, 55% were African American, and 14% reported having a history of malignancy. Participants with a history of malignancy had an average of 3 comorbid conditions, and differences across groups in terms of cardiovascular and lung disease incidence were noted. Controlled analyses revealed that recent cancer history (odds ratio [OR], 15.5; 95% confidence interval [CI], 7.0-34.2) and intermediate cancer history (OR, 2.1; 95% CI, 1.4-3.3) were associated with same-year hospital admission. In addition, having a recent history of malignancy in 1992 was found to be correlated with NH admission 4 years later (OR, 3.1; 95% CI, 1.1-9.1). History of malignancy was not associated with mortality. CONCLUSIONS. Cancer history had limited influence on healthcare use and mortality. Efforts aimed at improving health-related outcomes in older cancer survivors should continue to focus on attenuating the impact of comorbid conditions.

KW - Aged

KW - Cancer survivorship

KW - Comorbidity

KW - Healthcare use

KW - Mortality

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