Abstract
PurposeComorbidities have been indicated to influence cancer care and outcome, with strong associations between the presence of comorbidities and patient survival. The objective of this study is to determine the magnitude and pattern of comorbidities in Nigerian cancer populations, and demonstrate the use of comorbidity indices in predicting mortality/survival rates of cancer patients.MethodsUsing a retrospective study design, data were extracted from hospital reports of patients presenting for oncology care between January 2015 and December 2016 at two tertiary health facilities in Lagos, Nigeria. Patient comorbidities were ranked and weighted using the Charlson comorbidity index (CCI).ResultsThe mean age for the 848 cancer patients identified was 53.9 ± 13.6 years, with 657 (77.5%) females and 191 (22.5%) males. Breast (50.1%), cervical (11.1%) and colorectal (6.3%) cancers occurred most frequently. Comorbidities were present in 228 (26.9%) patients, with the most common being hypertension (20.4%), diabetes (6.7%) and peptic ulcer disease (2.1%). Hypertension-augmented CCI scores were 0 (15.6%), 1–3 (62.1%), 4–6 (21.7%) and ≥7 (0.6%). The mean CCI scores of patients ≤50 years (0.8 ± 0.9) and ≥51 years (3.3 ± 1.2) were significantly different (p < 0.05). Patients with lower mean CCI scores were more likely to receive chemotherapy (2.2 ± 1.6 versus 2.5 ± 1.9; p < 0.05) and/or surgery (2.1 ± 1.5 versus 2.4 ± 1.7; p < 0.05).ConclusionComorbidities occur significantly in Nigerian cancer patients and influence the prognosis, treatment outcome and survival rates of these patients. There is a need to routinely evaluate cancer patients for comorbidities with the aim of instituting appropriate multidisciplinary management measures where necessary.
Highlights
Cancer is one of the most commonly diagnosed conditions globally, and is a leading cause of death worldwide
The major morbidity and mortality burden are borne by developing countries as 70% of deaths from cancer occur in middle- and low-income nations [2]
The analysis included 848 patients who fulfilled the eligibility criteria with various types of cancers seen between January 2015 and December 2016
Summary
Cancer is one of the most commonly diagnosed conditions globally, and is a leading cause of death worldwide. The increasing cancer burden in developing countries such as Nigeria is a significant public health problem that governments are grappling with. The GLOBOCAN 2012 report showed that there were 14.1 million new cases of cancer, 8.2 million mortalities from cancer and 32.6 million people living with cancer worldwide in 2012 [1]. Of these huge figures, the major morbidity and mortality burden are borne by developing countries as 70% of deaths from cancer occur in middle- and low-income nations [2]. Bellizzi and Rowland [3] reported that 69–88% of cancer patients have at least one comorbidity. As a result of this, the treatment of such patients becomes convoluted and its impact on survival and quality of life becomes significant
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