Abstract
Patients with cancer often carry the dual burden of the cancer itself and other co-existing medical conditions. The problems associated with comorbidities among elderly cancer patients are more prominent compared with younger patients. This study aimed to identify common cancer-related comorbidities in elderly patients through routinely collected hospital discharge data and to use association rules to analyze the prevalence and patterns of these comorbidities in elderly cancer patients at different cancer sites. We collected the discharge data of 80,574 patients who were diagnosed with cancers of the esophagus, stomach, colorectum, liver, lung, female breast, cervix, and thyroid between 2016 and 2018. The same number of non-cancer patients were randomly selected as the control group and matched with the case group by age and gender. The results showed that cardiovascular diseases, metabolic diseases, digestive diseases, and anemia were the most common comorbidities in elderly patients with cancer. The comorbidity patterns differed based on the cancer site. Elderly patients with liver cancer had the highest risk of comorbidities, followed by lung cancer, gastrointestinal cancer, thyroid cancer, and reproductive cancer. For example, elderly patients with liver cancer had the higher risk of the comorbid infectious and digestive diseases, whereas patients with lung cancer had the higher risk of the comorbid respiratory system diseases. The findings can assist clinicians in diagnosing comorbidities and contribute to the allocation of medical resources.
Highlights
The incidence of cancer is rising rapidly worldwide due to the aging population [1]
Our study has shown that different cancer sites have different comorbidity patterns
This study used association rule mining [26] (ARM) from hospital discharge data to identify an extensive list of important comorbidities in cancer patients
Summary
The incidence of cancer (and cancer mortality rates) is rising rapidly worldwide due to the aging population [1]. It has been reported that more than one-half of patients with cancer >65 years of age often carry the dual burden of cancer itself and other co-existing chronic conditions [3,4]. Individuals have multiple medical conditions referred to as comorbidity [5]. Comorbidities potentially affect the stages of the cancer spectrum from diagnosis, through treatment, to outcome [6]. Patients with comorbidity are substantially more likely to experience complicate treatment, increased cost of care, decreased quality of life and lower survival probabilities than those without comorbidity [3,7].
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