Abstract
The aim of the present study was to apply the Charlson comorbidity index (CCI) to evaluate the impact of comorbidity on lung cancer mortality in individuals not exhibiting lung cancer at the commencement of follow-up. Data from 9,579 participants without lung cancer were extracted from the Liverpool Lung Project between 1999 and 2010 and linked to the Hospital Episode Statistics database. The occurrence of comorbidities was assessed one year prior to the individual inclusion date. CCI scores were computed and Cox regression analysis was used to evaluate the association between comorbidity and lung cancer mortality using a competitive risk approach. During a median follow-up of 11 years, 1,320/9,579 (13.7%) individuals developed lung cancer, of which 886 (67.1%) succumbed to lung cancer and 875 of the 9,579 individuals (9.1%) succumbed due to other causes. The severity of comorbidity was associated with higher lung cancer-specific mortality; low to moderate comorbidity exhibited a hazard ratio (HR) of 2.86 [95% confidence interval (CI), 1.17–7.02] and severe comorbidity exhibited an HR of 5.16 (95% CI, 2.07–12.89). Furthermore, the CCI score determined that the severity of comorbidity increased the risk of lung cancer-specific mortality. Thus, CCI score is a good predictor of lung cancer-specific mortality and the use of comorbidity burdens in the clinical management of lung cancer is recommended.
Highlights
Lung cancer is the leading cause of cancer‐related mortality in the majority of developed countries, with the mortality rate exceeding that of colon, breast and prostate cancer combined [1,2]
Of the participants that succumbed to lung cancer, a higher proportion smoked for a longer period of time compared with their counterparts that succumbed due to other causes
Significant differences were noted in other risk factors between the lung cancer‐specific and other‐cause mortality groups, including education (P
Summary
Lung cancer is the leading cause of cancer‐related mortality in the majority of developed countries, with the mortality rate exceeding that of colon, breast and prostate cancer combined [1,2]. Due to increasing longevity and rapid ageing populations, the number of individuals with more than one comorbid condition is expected to increase sharply in the forthcoming decades [5,6]. This increase may result in an increase in the incidence of lung cancer and the comorbidity burden may lead to increased overall and/or lung cancer‐specific mortality. The Charlson comorbidity index (CCI) is the most widely used indices in prognostic medicine [11]; it is a simple, readily applicable and valid weighted index developed for estimating the risk of mortality from comorbid diseases in longitudinal studies. The CCI was developed using the ninth revision of the International Classification of Diseases (ICD)‐9 diagnosis codes, it has yet to be validated using ICD‐10 [12,13]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
