PCN202 PREVALENCE OF PRE-EXISTING MULTIMORBIDITY AMONG OLDER PATIENTS WITH LATE-STAGE MELANOMA

Abstract

Presence of multimorbidity can affect prognosis, treatment, and outcomes of patients with cancer. We estimated the prevalence of any and type of pre-existing multimorbidity (autoimmune (AD), physical health (PHC), and mental health conditions (MHC)) among older adults with late-stage melanoma in the United States. We derived data on older fee-for-service Medicare beneficiaries (age >65 years) diagnosed with late-stage (stage III/IV) melanoma between 2011 and 2015 (N = 4,519) from the linked SEER cancer registry and Medicare claims. We defined multimorbidity as the prevalence of two or more chronic conditions prior to the diagnosis of melanoma. Further, PHC consisted of pre-existing AD, arthritis, asthma, coronary artery disease, cardiac arrhythmias, diabetes, congestive heart failure, chronic kidney disease, chronic obstructive pulmonary disease, hepatitis, hyperlipidemia, hypertension, human immunodeficiency virus, obesity, osteoporosis, and stroke while MHC consisted of anxiety, bipolar disorder, depression, psychoses, schizophrenia, and substance abuse. We further explored any multimorbidity using combinations of dyads and triads. Chi-square test was used to identify significant unadjusted associations of individual characteristics to multimorbidity. An overwhelming majority (85%) of older patients with late-stage melanoma had multimorbidity. Pre-existing PHC multimorbidity (84%) was the most prevalent, followed by AD (12%), and MHC (6%) multimorbidity. Among those with any multimorbidity, the most prevalent dyad combination was endocrine and musculoskeletal disorder combination (21.7%) followed by cardiovascular (CVD) and endocrine disorder combination (20.3%). Among triads, CVD, endocrine, and musculoskeletal disorder combination (22.6%) was the most prevalent followed by endocrine, MHC, and musculoskeletal disorder combination (7%). Although oncologists and other healthcare providers are aware of high prevalence of multimorbidity among older patients, evidence on prevalence in melanoma patients is lacking. This is the first real-world study to confirm oncologists’ suspicions and helps guide them to develop systematic approaches to optimize care of older patients with late-stage melanoma.