Prevalence of Comorbidities in Adult Veterans with Colorectal Cancer (CRC)

Abstract

Introduction: Colorectal cancer (CRC) is the third most commonly diagnosed cancer and the second leading cause of cancer deaths in the United States among cancers that affect both men and women. Several risk factors including age, heredity, environmental and life style actors, chronic diseases like hypertension and diabetes mellitus seem to influence the risk of developing CRC. Objective: Primary outcome: To determine prevalence of hypertension (HTN), diabetes mellitus (DM), chronic kidney disease (CKD), tobacco and alcohol abuse in adult veterans with CRC. Secondary outcome: a) to compare prevalence of these comorbidities in African American versus Caucasian patients. b) to determine association between number of comorbidities and age of CRC diagnosis. Methods: We retrospectively examined medical records of patients with biopsy proven diagnosis of CRC. Patients were identified from electronic data base. Charts were reviewed for established diagnosis of HTN, DM, CKD, Tobacco and Alcohol abuse. Results: Table 1: Demographics Male 362 Female 7 African American 74 Caucasian 295 Total 369 Median age 66.5 About 73.4 % (271) of patients had two or more comorbidities. No difference in the mean number of comorbidities (Mann-Whitney test p = 0.20) between the two groups. HTN (272, 73.1%) and tobacco abuse (237, 63.7%) were found to be the two most prevalent comorbidities. DM, CKD and alcohol abuse were identified in 40.3% (150), 15.3% (57) and 30.4% (113) of patients respectively. African Americans had higher prevalence of CKD (24.3 %) compared to Caucasians (13.2%) (Chi square test p = 0.0018). Patients with 3 or more comorbidities were diagnosed with CRC 3.12 years earlier than those with ≤ 1 comorbidities (Mann-Whitney test p = 0.048). Conclusion: The findings obtained in this study indicate that the patients with three or more comorbidities were diagnosed with CRC at a younger age compared to those with ≤ 1 comorbidities. A better understanding of chronic comorbidities in patients with CRC may guide strategies to decrease the morbidity and mortality associated with CRC.