Prevalence of Comorbidity and Impact On Survival in Women with Lung, Breast and Cervical Cancer

Abstract

Background: The relationship between cancer incidence and mortality, and the resulting comorbidities of the elderly reflects current demographics trends Objective: The study aimed to investigate the prevalence of comorbidities and their impact on survival of women diagnosed with: NSCLC, breast and cervical cancer, at the National Institute of Oncology and Radiobiology in Havana, Cuba. Methods: Data were collected retrospectively from patients' clinical charts. The study involved 138 NSCLC, 1 598 breast cancer and 631 cervical cancer registered during 2007-2011. Comorbidity was classified according to the ICD-10 diagnosis code and was measured using Charlson Comorbidity Index. Associations between comorbidities and mortality by all causes were analyzed in Cox regression models. Results: The highest prevalence of comorbidities was in NSCLC (68.8%). The 3-year OS for NSCLC were 44.5% (95%CI: 29.3–59.7) and 23.3% (95%CI: 13.2–33.4) in patients without and with comorbidity, respectively (p=.01). The 5-year OS for breast cancer in the no comorbidity group was 91.4% (95%CI: 89.6–91.6) compared with 37.2% (95%CI: 32.7-59.9) in the comorbodity group (p=.00). The 5-year OS for cervical cancer in patients without diseases was (55.8% [95%CI: 50.7 – 59.9]), in women with comorbidity (27.7% [95%CI: 15.9–29.5]) (p =.00). Comorbidity was an independent predictor for overall survival: NSCL (HR Adjusted: 2.28 [95%CI: 1.43 - 3.65], p=.000), breast cancer (HR Adjusted: 3.16 [95%CI: 2.69–3.71], p=.000), cervical cancer (HR Adjusted: 1.38 [95%CI: 1.10–1.86], p=.032) Conclusions: Comorbidity is an important prognostic factor for women diagnosed with lung, breast and cervical cancer.