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The Influence of Comorbidities on Overall Survival Among Older Women Diagnosed With Breast Cancer

The Influence of Comorbidities on Overall Survival Among Older Women Diagnosed With Breast Cancer BackgroundPrevious studies have shown that summary measures of comorbid conditions are associated with decreased overall survival in breast cancer patients. However, less is known about associations between specific comorbid conditions on the survival of breast cancer patients.MethodsThe Surveillance, Epidemiology, and End ResultsMedicare database was used to identify primary breast cancers diagnosed from 1992 to 2000 among women aged 66 years or older. Inpatient, outpatient, and physician visits within the Medicare system were searched to determine the presence of 13 comorbid conditions present at the time of diagnosis. Overall survival was estimated using age-specific KaplanMeier curves, and mortality was estimated using Cox proportional hazards models adjusted for age, race and/or ethnicity, tumor stage, cancer prognostic markers, and treatment. All statistical tests were two-sided.ResultsThe study population included 64034 patients with breast cancer diagnosed at a median age of 75 years. None of the selected comorbid conditions were identified in 37306 (58%) of the 64034 patients in the study population. Each of the 13 comorbid conditions examined was associated with decreased overall survival and increased mortality (from prior myocardial infarction, adjusted hazard ratio [HR] of death 1.11, 95% CI 1.03 to 1.19, P .006; to liver disease, adjusted HR of death 2.32, 95% CI 1.97 to 2.73, P < .001). When patients of age 6674 years were stratified by stage and individual comorbidity status, patients with each comorbid condition and a stage I tumor had similar or poorer overall survival compared with patients who had no comorbid conditions and stage II tumors.ConclusionsIn a US population of older breast cancer patients, 13 individual comorbid conditions were associated with decreased overall survival and increased mortality. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JNCI: Journal of the National Cancer Institute Oxford University Press

The Influence of Comorbidities on Overall Survival Among Older Women Diagnosed With Breast Cancer

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References (55)

Publisher
Oxford University Press
Copyright
The Author 2011. Published by Oxford University Press.
ISSN
0027-8874
eISSN
1460-2105
DOI
10.1093/jnci/djr188
pmid
21719777
Publisher site
See Article on Publisher Site

Abstract

BackgroundPrevious studies have shown that summary measures of comorbid conditions are associated with decreased overall survival in breast cancer patients. However, less is known about associations between specific comorbid conditions on the survival of breast cancer patients.MethodsThe Surveillance, Epidemiology, and End ResultsMedicare database was used to identify primary breast cancers diagnosed from 1992 to 2000 among women aged 66 years or older. Inpatient, outpatient, and physician visits within the Medicare system were searched to determine the presence of 13 comorbid conditions present at the time of diagnosis. Overall survival was estimated using age-specific KaplanMeier curves, and mortality was estimated using Cox proportional hazards models adjusted for age, race and/or ethnicity, tumor stage, cancer prognostic markers, and treatment. All statistical tests were two-sided.ResultsThe study population included 64034 patients with breast cancer diagnosed at a median age of 75 years. None of the selected comorbid conditions were identified in 37306 (58%) of the 64034 patients in the study population. Each of the 13 comorbid conditions examined was associated with decreased overall survival and increased mortality (from prior myocardial infarction, adjusted hazard ratio [HR] of death 1.11, 95% CI 1.03 to 1.19, P .006; to liver disease, adjusted HR of death 2.32, 95% CI 1.97 to 2.73, P < .001). When patients of age 6674 years were stratified by stage and individual comorbidity status, patients with each comorbid condition and a stage I tumor had similar or poorer overall survival compared with patients who had no comorbid conditions and stage II tumors.ConclusionsIn a US population of older breast cancer patients, 13 individual comorbid conditions were associated with decreased overall survival and increased mortality.

Journal

JNCI: Journal of the National Cancer InstituteOxford University Press

Published: Jul 20, 2011

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